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Original article Increased risk of cancer and cancer-related mortality in middle-aged Korean women with prediabetes and diabetes: a population-based study
Thi Xuan Mai Tran1orcid , Soyeoun Kim2orcid , Huiyeon Song3orcid , Boyoung Park1orcid
Epidemiol Health 2023;e2023080
DOI: https://doi.org/10.4178/epih.e2023080 [Accepted]
Published online: August 28, 2023
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1Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea, Seoul, Korea
2Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea, Seoul, Korea
3Graduate School of Public Health, Hanyang University, Korea, Seoul, Korea
Corresponding author:  Boyoung Park,
Email: hayejine@hanmail.net
Received: 28 April 2023   • Revised: 24 July 2023   • Accepted: 15 August 2023
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Abstract

Objectives
This study investigated the risk of developing and dying from all types of cancer, as well as cancer-specific mortality, in women diagnosed with prediabetes and diabetes.
Methods
We included women aged ≥40 years who underwent cancer screening from 2009 to 2014 with follow-up until 2020. Diabetes status was determined based on fasting plasma glucose levels, self-reported history of diabetes, and the use of antidiabetic medication. We quantified the risk of cancer and mortality in the prediabetes and diabetes groups, relative to the normoglycemia group, by calculating adjusted hazard ratios (aHRs).
Results
The study included 8,309,393 participants with a mean age of 52.7±9.7 years. Among these participants, 522,894 cases of cancer and 193,283 deaths were detected. An increased risk of cancer was observed in both the prediabetes group (aHR, 1.03; 95% CI, 1.02–1.04) and the diabetes group (aHR, 1.13; 95% CI, 1.12–1.14). The highest risk was identified in those with diabetes who developed liver (aHR, 1.72; 95% CI, 1.66–1.79), pancreatic (aHR, 1.68; 95% CI, 1.60–1.76), and gallbladder cancer (aHR, 1.43; 95% CI, 1.36–1.51). Women with prediabetes and diabetes exhibited a 1.07-fold (95% CI, 1.05–1.08) and 1.38-fold (95% CI, 1.36–1.41) increased risk of death from cancer, respectively.
Conclusions
Both prediabetes and diabetes were associated with an elevated risk of cancer, as well as an increased risk of death from cancer, in middle-aged Korean women. However, the degree of risk varied depending on the specific site of the cancer.

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