Risk analysis of malignant tumor incidence in pre-diabetes patients in Shanghai

doi:10.16138/j.1673-6087.2022.06.003

Abstract

Abstract:

Objective To explore the risk of incidence of over all cancer and site-specific cancers in patients with pre-diabetes. Methods From 2011 to 2018, 31 568 pre-diabetes patients aged 20 years and above who were newly diagnosed and registered in the community diabetes management information system of Shanghai were used as the unique identifier to link data with the Shanghai Malignant Tumor Registration System to obtain their malignant tumor incidence, to calculate the incidence of all causes and the top ten malignant tumors of pre-diabetes patients of different sexes and ages standardized incidence rate and standardized incidence ratio (SIR). Results The crude incidence rate of all cause tumors in pre-diabetes patients was 868.1/100 000 person years, 1 099.48/100 000 person years for male and 729.19/100 000 person years for female. The standardized incidence rate was 567.49/100 000 person years, 512.15/100 000 person years for male and 597.91/100 000 person years for female. The SIR of all cause tumors was 0.97, 0.99 for male and 0.99 for female, respectively. The relative incidence risk of all cause tumors in pre-diabetes patients gradually decreased with age, and the SIR of pre-diabetes patients in the 20-49, 50-59, 60-69, 70-79 and ≥80 age groups was 3.04, 1.21, 1.00, 0.92 and 0.66, respectively. The incidence risk of thyroid cancer in the 20-49 and 50-59 year old pre-diabetes patients were 4.85 and 1.86 times higher than that of the total population of the same age, respectively, and the incidence risk of thyroid cancer in the 20-49 and 50-59 year old female pre-diabetes patients were 4.46 and 1.53 times higher than that of the total population of the same sex and age, respectively. The risk of bladder cancer and kidney cancer in male under 50 years of age with pre-diabetes were 36.34 and 13.49 times higher than that in the total population of the same sex and age, respectively. The risk of prostate cancer in male aged 60 to 69 years in pre-diabetes was 2.66 times higher than that in total population of the same sex and age. Conclusions The risk of all-cause cancer in pre-diabetes patients was not significantly higher than that in the total population. The relative risk of all-cause cancer and site-specific cancers of the population decreased with age. It is necessary to increase the screening of specific cancer species in specific gender and age groups. For newly diagnosed pre-diabetes patients over 80 years old, it is recommended to reevaluate the risk of disease diagnosis and prognosis.

Key words: Prediabetes, Malignant tumor, Standard incidence ratio, Standard

CLC Number:

R587.1

MIAO Ya, LIU Lili, HOU Tianzhichao, YAN Qinghua, PANG Yi, WU Chunxiao, CHENG Minna, SHI Yan, LI Yanyun, TIAN Jingyan. Risk analysis of malignant tumor incidence in pre-diabetes patients in Shanghai[J]. Journal of Internal Medicine Concepts & Practice, 2022, 17(06): 435-440.

Figures/Tables 3

瘤别	20~49 岁	50~59 岁	60~69 岁	70~79 岁	≥80 岁
合计
全因肿瘤	3.04（1.99~4.09）	1.21（1.04~1.38）	1.00（0.91~1.09）	0.92（0.83~1.00）	0.66（0.54~0.78）
肺癌	1.29（0.04~7.17）	0.82（0.49~1.16）	1.03（0.83~1.23）	0.68（0.52~0.84）	0.59（0.35~0.83）
结直肠癌	3.38（0.41~12.19）	1.26（0.75~1.78）	0.78（0.56~0.99）	0.98（0.74~1.21）	0.39（0.16~0.62）
胃癌	4.45（0.53~16.05）	1.42（0.76~2.07）	1.08（0.77~1.39）	0.91（0.64~1.18）	0.54（0.22~0.86）
乳腺癌	2.83（0.06~5.59）	1.56（1.00~2.12）	1.04（0.70~1.38）	1.31（0.80~1.81）	1.56（0.54~2.57）
甲状腺癌	4.85（2.55~7.16）	1.86（1.25~2.46）	0.68（0.36~1.00）	1.14（0.29~1.98）	1.17（0.04~6.54）
肝癌		0.65（0.17~1.13）	0.86（0.51~1.21）	0.92（0.55~1.29）	1.12（0.53~1.71）
胰腺癌		1.54（0.40~2.68）	1.07（0.59~1.55）	1.06（0.63~1.48）	0.44（0.05~0.82）
膀胱癌	22.02（2.64~79.48）	0.66（0.08~2.40）	0.95（0.36~1.54）	0.96（0.44~1.48）	0.44（0.09~1.28）
中枢神经系统肿瘤		0.41（0.05~1.47）	0.57（0.15~1.00）	0.43（0.01~0.84）	0.79（0.16~2.31）
肾癌	7.00（0.84~25.26）	1.29（0.26~2.32）	0.55（0.14~0.96）	1.00（0.31~1.69）	0.80（0.10~2.88）
男性
全因肿瘤	2.87（0.88~4.86）	1.18（0.87~1.48）	1.13（0.98~1.28）	0.95（0.82~1.08）	0.64（0.48~0.80）
肺癌		0.75（0.23~1.26）	0.99（0.71~1.27）	0.67（0.46~0.88）	0.53（0.24~0.82）
结直肠癌		2.00（0.91~3.09）	0.95（0.61~1.30）	1.07（0.71~1.42）	0.36（0.04~0.67）
前列腺癌		2.16（0.26~7.79）	2.66（1.79~3.53）	1.23（0.82~1.64）	0.92（0.38~1.47）
胃癌		2.08（0.85~3.32）	1.28（0.83~1.73）	0.84（0.50~1.19）	0.69（0.21~1.16）
肝癌		0.74（0.01~1.46）	0.84（0.38~1.29）	1.42（0.80~2.04）	0.74（0.09~1.39）
胰腺癌		1.67（0.35~4.89）	0.95（0.29~1.60）	1.17（0.51~1.84）	0.62（0.13~1.82）
膀胱癌	36.34（4.36~131.18）	1.35（0.16~4.86）	1.05（0.27~1.82）	1.19（0.49~1.90）	0.40（0.05~1.43）
甲状腺癌	3.99（0.82~11.67）	1.49（0.03~2.95）	0.45（0.05~1.61）	1.55（0.19~5.59）
肾癌	13.49（1.62~48.69）	1.52（0.31~4.46）	0.75（0.09~1.41）	0.67（0.14~1.96）	0.71（0.02~3.98）
淋巴癌		0.92（0.03~5.14）	1.83（0.56~3.09）	1.48（0.38~2.58）	0.56（0.02~3.14）
女性
全因肿瘤	2.81（1.69~3.94）	1.21（1.01~1.41）	0.95（0.83~1.08）	0.95（0.81~1.08）	0.68（0.51~0.86）
乳腺癌	2.26（0.05~4.47）	1.13（0.72~1.53）	0.86（0.58~1.14）	1.18（0.73~1.63）	1.61（0.56~2.67）
肺癌	1.84（0.06~10.24）	1.03（0.51~1.56）	1.26（0.91~1.61）	0.82（0.52~1.12）	0.69（0.26~1.11）
结直肠癌	6.10（0.73~22.02）	0.95（0.36~1.54）	0.67（0.39~0.96）	0.94（0.61~1.26）	0.42（0.08~0.75）
甲状腺癌	4.46（2.13~6.80）	1.53（1.00~2.06）	0.64（0.31~0.96）	0.95（0.12~1.79）	1.58（0.05~8.82）
胃癌	6.79（0.81~24.52）	1.24（0.32~ 2.17）	1.06（0.54~1.59）	1.14（0.64~1.63）	0.34（0.07~0.99）
胰腺癌		1.80（0.04~3.56）	1.30（0.53~2.08）	0.98（0.43~1.54）	0.30（0.04~1.09）
肝癌		1.13（0.23~3.32）	1.22（0.46~1.97）	0.37（0.01~0.72）	1.56（0.54~2.57）
中枢神经系统肿瘤		0.49（0.06~1.77）	0.80（0.21~1.39）		1.28（0.26~3.75）
胆囊癌		1.33（0.16~4.82）	1.36（0.42~2.31）	1.29（0.53~2.05）	0.84（0.02~1.66）
子宫体癌	5.57（0.17~31.00）	0.88（0.02~1.75）	0.64（0.01~1.27）	1.00（0.21~2.92）	1.54（0.05~8.60）

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年度	随访时间（年）	年龄（岁）	男性[n（%）]	女性[n（%）]	合计[n（%）]
2011	7.27±1.22	65.15±10.56	1 309（36.95）	2 234（63.05）	3 543（11.22）
2012	6.31±1.03	65.94±10.10	2 226（38.34）	3 580（61.66）	5 806（18.39）
2013	5.41±0.79	65.65±9.56	1 865（36.37）	3 263（63.63）	5 128（16.24）
2014	4.40±0.65	65.98±9.60	1 854（38.54）	2 956（61.46）	4 810（15.24）
2015	3.51±0.46	66.68±9.63	1 502（38.76）	2 373（61.24）	3 875（12.28）
2016	2.36±0.28	64.28±9.74	1 587（40.08）	2 373（59.92）	3 960（12.54）
2017	1.51±0.27	65.76±9.65	954（41.37）	1 352（58.63）	2 306（7.30）
2018	0.54±0.16	67.18±9.35	911（42.57）	1 229（57.43）	2 140（6.78）
合计	4.39±2.22	65.76±9.83	12 208（38.67）	19 360（61.33）	31 568（100.00）
F/χ²	31 554.2	26.86	40.31
P	<0.000 1	<0.000 1	<0.000 1

瘤别	发病例数（n）	发病率（/10万人年）	ASR（/10万人年）	SIR（95%CI）
合计
全因肿瘤	1 206	868.10	567.49	0.97（0.91~1.02）
肺癌	213	151.27	53.71	0.81（0.70~0.92）
结直肠癌	155	110.06	51.74	0.85（0.72~0.98）
胃癌	121	85.84	44.70	0.97（0.80~1.15）
乳腺癌	105	74.54	63.78	1.30（1.05~1.55）
甲状腺癌	78	55.34	180.49	1.42（1.10~1.74）
肝癌	68	48.21	13.68	0.89（0.68~1.10）
胰腺癌	55	38.98	11.50	0.97（0.72~1.23）
膀胱癌	30	21.26	24.01	0.88（0.57~1.20）
中枢神经系统肿瘤	16	11.34	3.40	0.52（0.27~0.78）
肾癌	25	17.72	24.34	0.89（0.54~1.24）
男性
全因肿瘤	573	1 099.48	512.15	0.99（0.91~1.07）
肺癌	110	207.72	57.32	0.76（0.62~0.90）
结直肠癌	83	156.79	50.19	0.98（0.77~1.19）
前列腺癌	84	158.73	38.95	1.53（1.20~1.86）
胃癌	73	137.70	44.25	1.06（0.82~1.31）
肝癌	42	79.17	22.11	1.00（0.70~1.30）
胰腺癌	26	48.96	14.26	1.03（0.63~1.42）
膀胱癌	24	45.22	60.79	1.07（0.64~1.49）
甲状腺癌	11	20.72	81.86	1.17（0.48~1.86）
肾癌	14	26.37	57.93	0.96（0.46~1.46）
淋巴癌	17	32.02	8.62	1.41（0.74~2.08）
女性
全因肿瘤	633	729.19	597.91	0.99（0.91~1.06）
乳腺癌	105	119.65	101.03	1.07（0.87~1.28）
肺癌	103	117.24	51.09	1.00（0.81~1.20）
结直肠癌	72	81.92	53.79	0.78（0.60~0.96）
甲状腺癌	67	76.26	239.11	1.25（0.95~1.55）
胃癌	48	54.57	45.88	1.01（0.73~1.30）
胰腺癌	29	32.95	9.93	0.98（0.62~1.34）
肝癌	26	29.54	8.65	0.94（0.58~1.30）
中枢神经系统肿瘤	12	13.64	4.42	0.56（0.25~0.88）
胆囊癌	25	28.41	7.85	1.21（0.73~1.68）
子宫体癌	13	14.57	19.87	0.89（0.41~1.38）

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