Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies
| Autor: | David S. Lopez, John C. Kasimis, Konstantinos K. Tsilidis, John P. A. Ioannidis, Evangelia E. Ntzani |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Pathology business.industry Endometrial cancer Cancer Reproducibility of Results General Medicine Type 2 diabetes medicine.disease Diabetes Complications Systematic review Diabetes Mellitus Type 2 Risk Factors Diabetes mellitus Internal medicine Meta-analysis Neoplasms medicine Humans Observational study Female Gallbladder cancer business |
| Zdroj: | BMJ (Clinical research ed.). 350 |
| ISSN: | 1756-1833 |
| Popis: | Objectives To summarise the evidence and evaluate the validity of the associations between type 2 diabetes and the risk of developing or dying from cancer. Design An umbrella review of the evidence across meta-analyses of observational studies of type 2 diabetes with risk of developing or dying from any cancer. Data sources PubMed, Embase, Cochrane database of systematic reviews, and manual screening of references. Eligibility criteria Meta-analyses or systematic reviews of observational studies in humans that examined the association between type 2 diabetes and risk of developing or dying from cancer. Results Eligible meta-analyses assessed associations between type 2 diabetes and risk of developing cancer in 20 sites and mortality for seven cancer sites. The summary random effects estimates were significant at P=0.05 in 20 meta-analyses (74%); and all reported increased risks of developing cancer for participants with versus without diabetes. Of the 27 meta-analyses, eventually only seven (26%) compiled evidence on more than 1000 cases, had significant summary associations at P≤0.001 for both random and fixed effects calculations, and had neither evidence of small study effects nor evidence for excess significance. Of those, only six (22%) did not have substantial heterogeneity (I 2 >75%), pertaining to associations between type 2 diabetes and risk of developing breast, cholangiocarcinoma (both intrahepatic and extrahepatic), colorectal, endometrial, and gallbladder cancer. The 95% prediction intervals excluded the null value for four of these associations (breast, intrahepatic cholangiocarcinoma, colorectal, and endometrial cancer). Conclusions Though type 2 diabetes has been extensively studied in relation to risk of developing cancer and cancer mortality and strong claims of significance exist for most of the studied associations, only a minority of these associations have robust supporting evidence without hints of bias. |
| Databáze: | OpenAIRE |
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