Diabetes mellitus and risk of gastric cancer

Abstract

AIM: Increasing evidence suggests that a history of diabetes may be involved in the development of various sites of cancer. However, the association of diabetes and risk of gastric cancer (GC) remains unclear. METHODS: We identified studies by a literature search of MEDLINE (from 1 January 1966), Web of Science (from 1 January 1994), and EMBASE (from 1 January 1974 through 31 May 2011), and by searching the reference lists of pertinent articles. All data were extracted independently by two investigators using a standardized data abstraction tool. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Between-study heterogeneity was assessed using the Cochran's Q and I statistics. RESULTS: A total of 21 studies (four case-control studies, 17 cohort studies) were included in this meta-analysis. Analysis of these 21 studies found that compared with nondiabetic individuals, diabetic individuals had a similar risk of GC (SRRs, 1.09; 95% CI: 0.98-1.22). There was strong evidence of heterogeneity among these studies (P<0.001, I²=81.2%). A subgrouped analysis found that diabetic women had 18% increased risk of GC (SRRs, 1.18; 95% CI: 1.01-1.39), whereas it was not the case with diabetic men. No significant public bias was found in this study. CONCLUSION: These findings of this systematic review indicate that compared with nondiabetic individuals, diabetic women have an 18% increased risk of GC development. However, diabetic men have a similar risk of GC.