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Body older women dating Glendale index BMI was calculated as weight in kilograms divided by the square of height in meters. CI indicates confidence interval. Context Diabetes is a serious and costly disease that is becoming increasingly common in many countries. The role of diabetes as a cancer risk factor remains unclear.
Objective To examine the relationship between fasting serum glucose and diabetes and risk of all cancers and specific cancers in men and women in Korea.
De, Setting, and Participants Ten-year prospective cohort study of 1 Koreans men and women aged 30 to 95 years who received health insurance from the National Health Insurance Corp and had a biennial medical evaluation in with follow-up for up to 10 years. Main Outcome Measures Death from cancer and registry-documented incident cancer or hospital admission for Cary.
During the 10 years of follow-up, there were 20 cancer deaths in men and cancer deaths in women. By cancer site, the association was strongest for pancreatic cancer, comparing the highest and lowest strata in men HR, 1. For cancer incidence, the general patterns reflected those found for mortality. Conclusion In Korea, elevated fasting serum glucose levels and a women of diabetes are independent risk factors for several major cancers, and the risk tends to increase with an increased level of fasting serum glucose.
Diabetes mellitus is a serious and costly disease that is becoming increasingly common in many countries, including Korea. We conducted a prospective cohort investigation, the Korean Cancer Prevention Study KCPSamong more than 1 million Koreans to assess associations of fasting serum glucose and of a diagnosis of diabetes with cancer risk. Of the Korean population approximately Lakeland FL woman for dating All workers were required to participate in biennial medical examinations.
This examination included a lifestyle and medical questionnaire, along with korean of blood chemistries in a fasting blood sample. The KCPS cohort includes date Lincoln guys review Koreans men and women aged 30 to 95 years who received health insurance from NHIC and who had biennial medical evaluations during the period to By year, A total of people dating culture in New York a history of any form of cancer and who died in the interval between questionnaire completion and start of follow-up on January 1 of the subsequent year were also excluded, leaving a final sample size of 1 The Dating Corona CA aged men biennial examinations, conducted by medical staff at local hospitals, follow a standard procedure.
In the,and women, participants were asked 1 to describe their smoking habits, dating place in Green Bay with some other health habits, including alcohol consumption, and 2 if they speed dating Pembroke Pines FL expat being treated for diabetes, with the date of diagnosis if they answered yes.
Serum glucose measurements were obtained under fasting conditions for routine clinical purposes. Each hospital had Cary and external quality control procedures directed by the Korean Association of Laboratory Quality Control. All follow-up time of the participants was ased to korean first recorded serum glucose level. The follow-up period was up to 10 years, through December 31, The exact dates dating completion of the survey form were not recorded.
Consequently, follow-up accrual began on January 1 of the calendar year following the year in which the survey form was completed. Because the study involved routinely collected medical data, participant consent was not specifically obtained.
The principal outcome variables were mortality from cancer by site and cancer incidence, based on national cancer registry data and hospitalization records. Although Korea has a national cancer registry, reporting was not complete during Ontario date for couples time of follow-up and, consequently, hospital admission files were used to identify a first admission event for cancer.
An incident cancer case was coded as occurring based on either a positive report from the national cancer registry or on a hospital admission for a cancer diagnosis. Outcomes for mortality were ascertained from the causes of death on the death certificates. A computerized search of death certificate data from the National Statistical Office in Korea was performed using the unique Mississippi 18 dating ased at birth.
Causes of death are ased by trained hospital abstractors; for this analysis, we used underlying cause.
For some analyses, the upper of fasting glucose levels were combined Georgia durden dating a single stratum because of small s. Age-adjusted death and cancer incidence rates were calculated for each category of fasting serum glucose level and directly standardized to the age distribution of the Korean national population. All analyses were stratified by sex. We also calculated the attributable s of deaths associated with having elevated serum glucose levels, using standard methods. The population was primarily middle-aged, with approximately twice as many men as women Table 1.
The population had a low body mass index BMI; calculated as weight in kilograms divided by the square of height in meters on average, and only sweet home Brownsville TX dating show Both smoking and alcohol use were substantially more common in men. During the 10 years of follow-up, 54 deaths occurred among men and 20 among women.
As shown in Figure 1fasting serum glucose level was positively associated with all-cause man seeking women in Chicago Illinois IL rates. A total of 20 cancer deaths occurred soulmate dating Beaumont men and deaths occurred among women during the 10 years of follow-up.
In general, HR estimates were above unity for male participants in the higher strata of serum glucose level and among those with a diagnosis of diabetes Table 2. In fact, all point estimates were somewhat elevated in association with a diagnosis of diabetes.
We explored the relationship between duration of diabetes and cancer risk and did not find consistent associations, with the exception of pancreatic cancer in men. Among men with diabetes, the HRs for pancreatic cancer death with diabetes durations of less than 4.
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We observed linear trends in mortality with increasing fasting serum glucose level for date Corpus Christi TX girl in cancers combined and for cancers of several sites Table 2. For women, the overall pattern of association was similar to that in men Table 3with all point estimates increased for those with diabetes.
ificant positive linear trends in death rates were observed for pancreatic cancer; HRs ranged from 1. The s of incident cases during the 10 years of follow-up were 37 among men and 16 among women. Trends were generally similar for mortality and incidence. We observed positive linear trends in cancer i want to meet a Merced girl with increasing fasting serum glucose levels for cancers of the liver, pancreas, and kidney Table 4. The association of fasting serum glucose level and cancer incidence was similar whether the analysis was based on the total population or on those who had at least a 5-year follow-up period data not shown.
Furthermore, the incidence findings were unchanged with adjustment for BMI. For example, men with diabetes had similar HRs of death from pancreatic cancer before HR, 1. In women, positive linear trends were observed in incidence of pancreatic cancer with increasing fasting serum glucose level Table 5. The observed associations in women were unchanged with adjustment for BMI data not shown. For all cancers, a trend was evident in mortality risk by fasting serum glucose level in each stratum of BMI Figure 2.
Positive trends in death rates were observed for cancers of the liver and pancreas in all BMI groups as well. The risk of death due to liver and pancreatic cancers associated with fasting serum glucose level was not modified by BMI. For cancer incidence, the association of fasting serum glucose level with risk for liver cancer remained consistent and lacked evidence of effect modification by obesity.
The association of pancreatic cancer incidence with fasting serum glucose level was not as consistent hookup clearance Bremerton for mortality, free hookups Huntsville all strata showed increased risk compared with the reference category.
We also assessed potential modification of the effect of serum glucose level by smoking and alcohol consumption.
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We did not find ificant interactions for cancer incidence or mortality in either men or women. This cohort of Koreans, Cary comparison with Western populations, is notable for the low frequency of obesity in its participants. Date in Columbia free average BMI was Based on other studies in Korea, almost all cases of diabetes could be expected to be type 2. Other studies have addressed diabetes or glucose intolerance and risk for cancer. Although diverse in de and in their measures of glucose intolerance, the majority women shown that increased cancer risk, either overall or for particular cancer sites, is associated dating glucose intolerance.
The magnitude of the association of glucose intolerance or diabetes with risk for all cancers was small in the KCPS but was within the range found in some studies. The association of serum glucose best Minnesota to meet a wealthy man with cancer risk did not vary by BMI Figure 2. The study confirmed the excess risk of digestive cancers reported in several korean, 568 particularly of cancers of the pancreas, liver, esophagus, and colon among persons with diabetes.
For pancreatic cancer, a meta-analysis of cohort and case-control studies estimated a 2-fold increase in risk of pancreatic cancer, comparing patients with and without diabetes. In the KCPS, we observed a ificant positive linear trend for risk of pancreatic cancer with fasting glucose level: the HR was 1.
The complementary findings with these exposure measures, serum glucose level, and report of diabetes, and the presence of a dose-response relationship with fasting serum glucose level support a causal interpretation of these associations. The findings for several other cancer sites further support this interpretation. Other studies have also found increased latino dating Fargo for these cancer sites. On hospital admission diagnoses, we found little mention of nonalcoholic steatotic hepatitis, suggesting that the increased risk of liver cancer associated with higher serum glucose level reflects a direct pathway rather than an indirect pathway through obesity and fatty liver damage.
Fasting serum glucose level and cancer risk in korean men and women
For prostate cancer, for both incidence and mortality, we found no evidence for an association with either fasting serum glucose level or diabetes Table 2 and Table 4consistent with other dating naked Lafayette. Hyperinsulinemia has been cited as a possible Tacoma divorced woman dating factor for breast cancer, and supporting laboratory findings have been reported, 5 but of epidemiological studies have been mixed.
The association was apparent among postmenopausal women but not among premenopausal women. With stratification at age 55 years, we did not find increased risk in the older stratum, corresponding to an age range when most women would be postmenopausal. The potential limitations of our study result primarily from using data collected for clinical purposes.
Serum glucose was measured under fasting conditions using clinical laboratories operating with standard quality assurance and control protocols in place. We do not anticipate that these clinical data would artifactually introduce association of cancer risk with fasting serum glucose level.
Cancer mortality is subject to misclassification on death certificates, particularly with regard to attribution to a particular site.
The limitations of death certificate data on cancer have been characterized in some countries, 2728 but we are uncertain as to the applicability of the findings of these studies in Korea. A small study within KCPS showed high validity for a death certificate listing of lung cancer. We were able to take dating in South Bend tips confounding by smoking and alcohol consumption into and explored effect modification by obesity.
We cannot attribute the associations of fasting serum glucose level and diabetes to uncontrolled confounding, particularly given the dose-response relationships observed with glucose. While the generalizability of the findings is uncertain, we have shown that fasting serum glucose level and diabetes are associated with cancer risk in a population far leaner than the Western populations dating bikers Alaska other studies.
These associations do not reflect confounding by obesity, suggesting that the mechanism of increased cancer risk reflects the consequences of hyperinsulinemia.
Glucose intolerance may be one pathway by which obesity increases cancer risk, and rising obesity may increase future cancer rates.