Diabetes is associated with increased lung cancer risk in women

  • Yi ZH & al.
  • Eur J Clin Invest
  • 26 Jun 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Diabetes is associated with a significantly increased risk for lung cancer for women, with mixed results for men and the overall population in sensitivity analyses.
  • Results are from a large meta-analysis of cohort studies.

Why this matters

  • Previous meta-analyses of diabetes and lung cancer risk included both cohort and case-control studies, which could increase risk for relationship bias.

Study design

  • Meta-analysis of 20 cohort studies including 12,441,459 individuals.
  • Funding: National Natural Science Foundation of China; others.

Key results

  • With all studies included, diabetes and lung cancer risk were not associated:
    • Relative risk (RR): 1.10 (P=.087).
    • High heterogeneity across studies: I2=97.2% (P<.001>
  • Only 1 large cohort study, from the US Department of Veterans Affairs (USVA), found no link both overall and among men (it did not include women). 
    • On sensitivity analyses, with the exclusion of the USVA study, the overall association became significant:
      •  RR, 1.13 (P<.001>
  • With the USVA study included, an association was not seen in men: 
    • RR: 1.11 (P=0.270).
    • Heterogeneity was high across studies: I2=98.1% (P<.001>
  • Without the USVA study, the association was significant for men: 
    • RR: 1.17 (P
  • Diabetes was associated with a significant increase in lung cancer risk in women with all studies included:
    • RR: 1.18 (P<.001>
    • Sensitivity analyses yielded similar results.

Limitations

  • Adjustments for confounders were inconsistent among included studies.