Diabetes mellitus and the risk of gastric cancer: a meta-analysis of cohort studies
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Zhi-Feng Miao1,*, Hao Xu1,*, Ying-Ying Xu2, Zhen-Ning Wang1, Ting-Ting Zhao2, Yong-Xi Song1 and Hui-Mian Xu1
1 Department of Surgical Oncology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
2 Department of Breast Surgery, First Hospital of China Medical University, Shenyang, Liaoning Province, China
* These authors have contributed equally to this article
Hui-Mian Xu, email:
Keywords: gastric cancer, diabetes mellitus, meta-analysis, gender, prognosis
Received: August 10, 2016 Accepted: March 14, 2017 Published: March 22, 2017
Studies examining the relationship between diabetes mellitus (DM) and the risk of gastric cancer incidence or gastric cancer mortality have produced inconsistent results. The purpose of this study was to evaluate the evidence regarding the relationship between DM and subsequent gastric cancer incidence or gastric cancer mortality risk on the basis of cohort studies. A systematic search of articles in PubMed, EmBase, the Cochrane Library, and reference lists was conducted to identify relevant literature. Twenty-two cohort studies reporting data on 8,559,861 participants were included in the study. Overall, participants with DM had little or no change in the risk of gastric cancer, or gastric cancer mortality. There was no evidence of difference in the RR for gastric cancer between men and women. Participants with DM had a non-significant trend towards an increased risk of gastric cancer mortality in men. There was no significant difference between men and women for this relationship. Finally, although subgroup analysis suggested DM was associated with a significant impact on gastric cancer incidence and gastric cancer mortality risk in several specific populations, a significance based on gender difference was not observed. In conclusion, DM might increase the risk of gastric cancer in men when the study used standard incidence/mortality ratio as effect estimate. Further, DM were associated with higher risk of gastric cancer mortality in men if the mean age at baseline less than 55.0 years, used RR or HR as effect estimate, the study adjusted smoking or not, and the study not adjusted alcohol drinking.
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