ArticlePloS one2013
Cancer incidence and mortality in patients with type 2 diabetes treated with human insulin: a cohort study in Shanghai.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 6 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 6 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Thiazolidinediones, alpha-glucosidase inhibitors, meglitinides, sulfonylureas, and hepatocellular carcinoma risk: A meta-analysis.Metabolism: clinical and experimental · 2021Pooled it
- Treatment with insulin (analogues) and breast cancer risk in diabetics; a systematic review and meta-analysis of in vitro, animal and human evidence.Breast cancer research : BCR · 2015Pooled it
- Insulin therapy and the risk of colorectal cancer in patients with type 2 diabetes: a meta-analysis of observational studies.British journal of clinical pharmacology · 2014Pooled it
- Insulin therapy and colorectal cancer risk among type 2 diabetes mellitus patients: a systemic review and meta-analysis.Diagnostic pathology · 2014Pooled it
- Conventional hypoglycaemic agents and the risk of lung cancer in patients with diabetes: a meta-analysis.PloS one · 2014 · on this mapPooled it
- Insulin therapy and risk of prostate cancer: a systematic review and meta-analysis of observational studies.PloS one · 2013Pooled it
- Causality between insulin use and malignant tumors of the digestive system: a two-sample mendelian randomized study.BMC cancer · 2025Article
- Anti-Diabetic Drugs: Cure or Risk Factors for Cancer?Pathology oncology research : POR · 2018Review
- Incidence and Mortality Risks of Cancer in Patients with Type 2 Diabetes: A Retrospective Study in Shanghai, China.International journal of environmental research and public health · 2016Article
- Determinants of mortality in patients with type 2 diabetes: a review.Reviews in endocrine & metabolic disorders · 2016Review
- Evidence for DNA damage as a biological link between diabetes and cancer.Chinese medical journal · 2015Review
- Diabetes and cancer: A critical appraisal of the pathogenetic and therapeutic links.Biomedical reports · 2015Article
- The association between type 2 diabetes mellitus and women cancer: the epidemiological evidences and putative mechanisms.BioMed research international · 2015Review
Corrections and comments
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Authors and funding
17 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe aim was to investigate the association between human insulin and cancer incidence and mortality in Chinese patients with type 2 diabetes.
methodsWe recruited 8,774 insulin-naïve diabetes patients from the Shanghai Diabetes Registry (SDR). The follow-up rate was 85.4%. All subjects were divided into the insulin use cohort (n = 3,639) and the non-insulin use cohort (n = 5,135). The primary outcome was the first diagnosis of any cancer. The secondary outcome was all-cause mortality. Cox proportional hazards model was used to estimate the relative risk (RR) of cancer and mortality.
resultsWe observed 98 cancer events in the insulin use cohort and 170 in the non-insulin use cohort. Cancer incidence rates were 78.6 and 74.3 per 10,000 patients per year in the insulin users and the non-insulin users, respectively. No significant difference in cancer risk was observed between the two cohorts (adjusted RR = 1.20, 95% CI 0.89-1.62, P = 0.228). Regarding site-specific cancers, only the risk of liver cancer was significantly higher in the insulin users compared to that in the non-insulin users (adjusted RR = 2.84, 95% CI 1.12-7.17, P = 0.028). The risks of overall mortality (adjusted RR = 1.89, 95% CI 1.47-2.43, P<0.0001) and death from cancer (adjusted RR = 2.16, 95% CI 1.39-3.35, P = 0.001) were all significantly higher in the insulin users than in the non-insulin users.
conclusionThere was no excess risk of overall cancer in patients with type 2 diabetes who were treated with human insulin. However, a significantly higher risk of liver cancer was found in these patients. Moreover, insulin users showed higher risks of overall and cancer mortality. Considering that individuals treated with insulin were more likely to be advanced diabetic patients, caution should be used in interpreting these results.
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