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Risk of esophageal cancer in diabetes mellitus: a meta-analysis of observational studies

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Abstract

Objective

Inconsistent findings from observational studies have prolonged the controversy over the effects of history of diabetes mellitus (DM) on the risk of esophageal cancer (EC). We conducted a meta-analysis of epidemiologic studies to evaluate the association of a history of DM with the risk of EC.

Methods

We identified studies by a literature search of MEDLINE (from 1 January 1966) and EMBASE (from 1 January 1974), through 28 Feburary 2011, and by searching the reference lists of pertinent articles. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. All statistical tests were two-sided.

Results

A total of 17 studies (6 case–control studies and 11 cohort studies) fulfilled the inclusion and exclusion criteria. Compared with non-diabetic individuals, diabetic individuals had a modestly increased risk of EC (SRRs 1.30, 95% CI: 1.12–1.50), with significant heterogeneity among studies (p = 0.042). In stratified analysis, the SRRs of EC were 1.28 (1.10–1.49) for diabetic men and 1.07 (95% CI, 0.71–1.62) for diabetic women, respectively. In addition, DM was associated with an increased risk of esophageal adenocarcinoma (SRR 2.12, 95% CI 1.01–4.46). There was no significant publication bias (p = 0.127 for Begg’s adjusted rank correlation test and p = 0.629 for Egger’s regression test).

Conclusion

These findings support the hypothesis that men with diabetes may have a modestly increased risk of EC, while diabetic women were not the case.

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Abbreviations

DM:

Diabetes mellitus

EC:

Esophageal cancer

ESCC:

Esophageal squamous cell carcinoma

EAC:

Esophageal adenocarcinoma

AORs:

Adjusted odds ratios

SRRs:

Summary relative risks

CI:

Confidence intervals

IGFs:

Insulin-like growth factors

SIR/SMR:

Standardized incidence/mortality ratio

HR:

Hazard ratio

BMI:

Body mass index

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There are no potential conflicts of interest among all authors.

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Correspondence to Zhaoshen Li.

Additional information

Wen Huang and Hongbo Ren contributed equally to this work.

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Huang, W., Ren, H., Ben, Q. et al. Risk of esophageal cancer in diabetes mellitus: a meta-analysis of observational studies. Cancer Causes Control 23, 263–272 (2012). https://doi.org/10.1007/s10552-011-9874-9

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  • DOI: https://doi.org/10.1007/s10552-011-9874-9

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