ALEXANDRIA, VA, Jun 16 (MARKET WIRE) —
A new consensus statement of experts assembled by the American Diabetes
Association and the American Cancer Society reviews emerging evidence
that suggests cancer incidence is associated with diabetes as well as
certain diabetes risk factors and treatments. The new report reviews the
state of science concerning the association between diabetes and cancer
incidence/prognosis; risk factors common to both diseases; possible
biologic links between diabetes and cancer risk; and whether diabetes
treatments influence the risk of cancer or cancer prognosis. In addition,
the report outlines key unanswered questions for future research.

Diabetes and cancer are common diseases that have a tremendous impact on
health worldwide. Epidemiologic evidence suggests that people with
diabetes are at a significantly higher risk of many forms of cancer. Type
2 diabetes and cancer share many risk factors, but potential biologic
links between the two diseases are not completely understood. Moreover,
evidence from observational studies suggests that some medications used
to treat hyperglycemia are associated with either an increased or reduced
risk of cancer. Against this backdrop, the American Diabetes Association
and the American Cancer Society convened a consensus development
conference in December 2009. After a series of scientific presentations
by experts in the field, the writing group independently developed a
consensus report to address important questions: Is there a meaningful
association between diabetes and cancer incidence or prognosis? What risk
factors are common to both cancer and diabetes? What are possible
biologic links between diabetes and cancer risk? And do diabetes
treatments influence cancer risk or cancer prognosis?

For each of these areas, the authors were asked to address current gaps
in evidence and potential research and epidemiologic strategies for
developing more definitive evidence in the future. Below is a summary of
their findings and recommendations.*

– Diabetes (primarily type 2) is associated with an increased risk of
some cancers (liver, pancreas, endometrium, colon/rectum, breast, and
bladder). Diabetes is associated with a reduced risk of prostate
cancer. For some other cancer sites, there appears to be no
association or the evidence is inconclusive.
– The association between diabetes and some cancers may be due in part
to shared risk factors between the two diseases such as aging,
obesity, diet, and physical inactivity.
– Possible mechanisms for a direct link between diabetes and cancer
include hyperinsulinemia, hyperglycemia, and inflammation.
– Healthy diet, physical activity, and weight management reduce the risk
and improve outcomes of type 2 diabetes and some forms of cancer and
should be promoted for all.
– Patients with diabetes should be strongly encouraged by their health
care professionals to undergo appropriate cancer screenings as
recommended for all people of their age and sex.
– The evidence for specific drugs affecting cancer risk is limited, and
observed associations may have been confounded by indications for
specific drugs, effects on other cancer risk factors such as body
weight and hyperinsulinemia, and the complex progressive nature of
hyperglycemia and pharmacotherapy in type 2 diabetes.
– Although still limited, early evidence suggests that metformin is
associated with a lower risk of cancer and that exogenous insulin is
associated with an increased cancer risk. Further research is needed
to clarify these issues and evaluate the possible association of
insulin and other diabetes medications with the risk of cancer.
– Cancer risk should not be a major factor when choosing between
available diabetes therapies for the average patient. For selected
patients with a very high risk of cancer occurrence (or for recurrence
of specific cancer types), these issues may require more careful
consideration.
– Many research questions remain.

“Traditionally there hasn’t been much overlap between research in
cancer and in diabetes,” says Edward Giovannucci, MD, SCD, co-chair of
the consensus report group. “But recently it’s become clearer that there
are fascinating links between the two. Our summary may raise more
questions than provide answers, but we hope that it will spur additional
studies.”

“The vast majority of patients with diabetes need not consider cancer
risk when weighing their diabetes therapy options,” added David M.
Harlan, MD, co-chair of the consensus report group, “Only patients with a
very high risk for cancer occurrence, or re-occurrence, may wish to
carefully consider their options. Even then, the association appears to
exist for some cancer types, and not for others. We have much to learn.”

*Recommendations in this report are solely the opinions of the authors
and do not represent the official position of the American Diabetes
Association or the American Cancer Society

Article: “Diabetes and Cancer: A Consensus Report.” Edward Giovannucci,
MD, ScD; David M. Harlan, MD; Michael C. Archer, MA, PhD, DSC; Richard M.
Bergenstal, MD; Susan M. Gapstur, PhD; Laurel A. Habel, PhD; Michael
Pollak, MD; Judith G. Regensteiner, PhD; Douglas Yee, MD. Diabetes Care,
Published Online: June 16, 2010; Print Issue Date: July 2010.

Diabetes Care, published by the American Diabetes Association, is the
leading peer-reviewed journal of clinical research into one of the
nation’s leading causes of death by disease. Diabetes also is a leading
cause of heart disease and stroke, as well as the leading cause of adult
blindness, kidney failure, and non-traumatic amputations.

The American Diabetes Association is leading the fight to stop diabetes
and its deadly consequences and fighting for those affected by diabetes.
The Association funds research to prevent, cure and manage diabetes;
delivers services to hundreds of communities; provides objective and
credible information; and gives voice to those denied their rights
because of diabetes. Founded in 1940, our mission is to prevent and cure
diabetes and to improve the lives of all people affected by diabetes. For
more information please call the American Diabetes Association at
1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information
from both these sources is available in English and Spanish.

Contact:
Dayle Kern
(703) 549-1500 ext. 2290
dkern@diabetes.org

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