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Ho NT, Abe SK, Rahman MS, Islam R, Saito E, Gupta PC, Pednekar MS, Sawada N, Tsugane S, Tamakoshi A, Kimura T, Shu XO, Gao YT, Koh WP, Cai H, Wen W, Sakata R, Tsuji I, Malekzadeh R, Pourshams A, Kanemura S, Kim J, Chen Y, Ito H, Oze I, Nagata C, Wada K, Sugawara Y, Park SK, Shin A, Yuan JM, Wang R, Kweon SS, Shin MH, Poustchi H, Vardanjani HM, Ahsan H, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D, Boffetta P. Diabetes is associated with increased liver cancer incidence and mortality in adults: A report from Asia Cohort Consortium. Int J Cancer 2024. [PMID: 38661292 DOI: 10.1002/ijc.34965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024]
Abstract
There has been growing evidence suggesting that diabetes may be associated with increased liver cancer risk. However, studies conducted in Asian countries are limited. This project considered data of 968,738 adults pooled from 20 cohort studies of Asia Cohort Consortium to examine the association between baseline diabetes and liver cancer incidence and mortality. Cox proportional hazard model and competing risk approach was used for pooled data. Two-stage meta-analysis across studies was also done. There were 839,194 subjects with valid data regarding liver cancer incidence (5654 liver cancer cases [48.29/100,000 person-years]), follow-up time and baseline diabetes (44,781 with diabetes [5.3%]). There were 747,198 subjects with valid data regarding liver cancer mortality (5020 liver cancer deaths [44.03/100,000 person-years]), follow-up time and baseline diabetes (43,243 with diabetes [5.8%]). Hazard ratio (HR) (95% confidence interval [95%CI]) of liver cancer diagnosis in those with vs. without baseline diabetes was 1.97 (1.79, 2.16) (p < .0001) after adjusting for baseline age, gender, body mass index, tobacco smoking, alcohol use, and heterogeneity across studies (n = 586,072; events = 4620). Baseline diabetes was associated with increased cumulative incidence of death due to liver cancer (adjusted HR (95%CI) = 1.97 (1.79, 2.18); p < .0001) (n = 595,193; events = 4110). A two-stage meta-analytic approach showed similar results. This paper adds important population-based evidence to current literature regarding the increased incidence and mortality of liver cancer in adults with diabetes. The analysis of data pooled from 20 studies of different Asian countries and the meta-analysis across studies with large number of subjects makes the results robust.
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Grants
- UM1CA173640 Shanghai Men's Health Study (SMHS): The US National Cancer Institute
- C20/A5860 Cancer Research UK Manchester Centre
- Singapore Chinese Health Study: The US National Cancer Institute
- 81/15 Golestan Cohort Study: Tehran University of Medical Sciences
- 2016R1A2B4014552 Korean Multicenter Cancer Cohort (KMCC): the National Research Foundation of Korea (NRF) grant funded by the Korea government
- Pars Cohort Study (PCS): Shiraz university of Medical Sciences Shiraz Iran, Digestive Diseases Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
- 3 Prefecture Miyagi Study: National Cancer Center Research and Development Fund
- UM1CA182910 Shanghai Women's Health Study (SWHS): The US National Cancer Institute
- Takayama Study: National Cancer Center Research and Development Fund
- Ohsaki Cohort Study: National Cancer Center Research and Development Fund
- Japan Collaborative Cohort Study (JACC): National Cancer Center Research and Development Fund, A Grant-in-Aid for Cancer Research; Grant for Health Services and Grant for Comprehensive Research on Cardiovascular and Life-Style Related Diseases from the Ministry of Health, Labour and Welfare, Japan; Grant for the Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan
- HCRI21019 The Namwon Study: Chonnam National University Hwasun Hospital Research grant
- HCRI18007-1 The Namwon Study: Chonnam National University Hwasun Hospital Research grant
- HCRI16911-1 The Namwon Study: Chonnam National University Hwasun Hospital Research grant
- 1510040 Korean National Cancer Center Cohort (KNCC): National Cancer Center Research and Development of Korea
- 1810090 Korean National Cancer Center Cohort (KNCC): National Cancer Center Research and Development of Korea
- 1910330 Korean National Cancer Center Cohort (KNCC): National Cancer Center Research and Development of Korea
- HVM18.01 Research Grant of Vinmec Healthcare System, Hanoi, Vietnam
- 23-A-31(toku) Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2: National Cancer Center Research and Development Fund (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010)
- 26-A-2 Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2: National Cancer Center Research and Development Fund (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010)
- 29-A-4 Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2: National Cancer Center Research and Development Fund (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010)
- 2020-A-4 Japan Public Health Center-based prospective Study (JPHC Study) 1 and 2: National Cancer Center Research and Development Fund (since 2011) and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (from 1989 to 2010)
- The intramural research program of the NCI, NIH USA; IARC/WHO Lyon France
- Life Span Study Cohort (LSS): The Japanese Ministry of Health, Labour, and Welfare and the U.S. Department of Energy
- 30-A-15 ACC Coordinating Center: National Cancer Center Research and Development Fund
- Health Effects of Arsenic Longitudinal Study (HEALS): National Institute of Environmental Health Science
- Mumbai Cohort Study: International Agency for Research on Cancer, Lyon, France; Clinical Trials Service Unit, Oxford, UK; World Health Organization, Geneva, Switzerland
- Miyagi Cohort Study: National Cancer Center Research and Development Fund
- R01CA0403092 Shanghai Cohort Study: National Institutes for Health
- R01CA144034 Shanghai Cohort Study: National Institutes for Health
- UM1CA182876 Shanghai Cohort Study: National Institutes for Health
- 3 Prefecture Aichi Study: The Japanese Ministry of the Environment (formerly, Environment Agency)
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Affiliation(s)
- Nhan Thi Ho
- Research Management Department, Vinmec Healthcare System, Hanoi, Vietnam
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Md Shafiur Rahman
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Rashedul Islam
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, India
| | | | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourshams
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jeongseon Kim
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea
| | - Yu Chen
- Department of Population Health and Environmental Medicine, New York University, New York, New York, USA
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Oze
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yumi Sugawara
- Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University Graduate School of Public Health, Sendai, Japan
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Renwei Wang
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hossein Poustchi
- Digestive Disease Research institute Tehran University of Medical Science, Tehran, Iran
| | - Hossein Molavi Vardanjani
- MD-MPH Dual Degree Program, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Science, Shiraz, Iran
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - You-Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, New York, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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