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.
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 diabeticmen and 1.07 (95% CI, 0.71-1.62) for diabeticwomen, 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 diabeticwomen were not the case.
Authors: Jessica L Petrick; Jake E Thistle; Anne Zeleniuch-Jacquotte; Xuehong Zhang; Jean Wactawski-Wende; Alison L Van Dyke; Meir J Stampfer; Rashmi Sinha; Howard D Sesso; Catherine Schairer; Lynn Rosenberg; Thomas E Rohan; Kim Robien; Mark P Purdue; Jenny N Poynter; Julie R Palmer; Christina C Newton; Martha S Linet; Linda M Liao; I-Min Lee; Jill Koshiol; Cari M Kitahara; Jonathan N Hofmann; Barry I Graubard; Edward Giovannucci; Michael J Gaziano; Susan M Gapstur; Neal D Freedman; Dawn Q Chong; Andrew T Chan; Julie E Buring; Laura Beane E Freeman; Peter T Campbell; Katherine A McGlynn Journal: Am J Gastroenterol Date: 2018-09-03 Impact factor: 10.864