| アブストラクト | PURPOSE: Preexisting diabetes is associated with increased morbidity and mortality in cancer. We examined the impact of incident cancer on the long-term outcomes of diabetes. METHODS: Using the United Kingdom Clinical Practice Research Datalink, we identified three cohorts of diabetes patients subsequently diagnosed with breast, colorectal, or prostate cancer, each matched to diabetic noncancer controls. Patients were required to have survived at least 1 year after cancer diagnosis (cases) or a matched index date (controls), and were followed up to 10 years for incident microvascular and macrovascular complications and mortality. Multivariate competing risks regression analyses were used to compare outcomes between cancer patients and controls. RESULTS: Overall, there were 3382 cancer patients and 11,135 controls with 59,431 person-years of follow-up. In adjusted analyses, there were no statistically significant (p </= 0.05) differences in diabetes complication rates between cancer patients and their controls in any of the three cancer cohorts. Combined, cancer patients were less likely (adjusted hazard ratio [HR] 0.88; 95% CI = 0.79-0.98) to develop retinopathy. Cancer patients were more likely to die of any cause (including cancer), but prostate cancer patients were less likely to die of causes associated with diabetes (HR 0.61; 95% CI = 0.43-0.88). CONCLUSIONS AND IMPLICATIONS: There is no evidence that incident cancer had an adverse impact on the long-term outcomes of preexisting diabetes. IMPLICATIONS FOR CANCER SURVIVORS: These findings are important for cancer survivors with preexisting diabetes because they suggest that substantial improvements in the relative survival of several of the most common types of cancer are not undermined by excess diabetes morbidity and mortality. |
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| 投稿者 | Griffiths, Robert I; Valderas, Jose M; McFadden, Emily C; Bankhead, Clare R; Lavery, Bernadette A; Khan, Nada F; Stevens, Richard J; Keating, Nancy L |
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| 組織名 | Nuffield Department of Primary Care Health Sciences, University of Oxford,;Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road,;Oxford, OX2 6GG, UK. robert.griffiths@conted.ox.ac.uk.;Division of General Internal Medicine, Johns Hopkins University School of;Medicine, Baltimore, 21205, USA. robert.griffiths@conted.ox.ac.uk.;Health Services & Policy Research Group and Exeter Collaboration for Primary Care;(APEx), University of Exeter, Exeter, EX4 4SB, UK.;Oxford, OX2 6GG, UK.;Oxford University Hospitals NHS Trust, Oxford, OX3 9DU, UK.;Thames Valley Strategic Clinical Network, NHS England, Leeds, UK.;Royal Liverpool University Hospital, L7 8XP, Liverpool, UK.;Department of Health Care Policy, Harvard Medical School, Boston, 02115, USA.;Division of General Internal Medicine and Primary Care, Brigham and Women's;Hospital, Boston, 02115, USA. |
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