Mortality From Site-Specific Malignancies in Type 2 Diabetic Patients From Verona
- 1Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
- 2Division of Endocrinology and Metabolic Diseases, University of Verona, Verona, Italy
OBJECTIVE— The aim of the present work was to compare mortality from site-specific malignancies in type 2 diabetic patients with those in the general population.
RESEARCH DESIGN AND METHODS— Mortality from site-specific cancers was assessed in a population-based cohort of 7,148 type 2 diabetic patients from Verona (Northern Italy) during a 10-year follow-up (1987–1996) by reviewing death certificates. Standardized mortality ratio (SMR) data were computed using as reference mortality rates in the general population of Verona.
RESULTS— During follow-up, 641 patients (378 men and 263 women) died of malignancies. The most common causes of death among site-specific malignancies were digestive tumors both in men (140 of 378, 37.0%) and women (105 of 263, 39.9%), respiratory tumors in men (103 of 378, 27.2%), and tumors of the reproductive system in women (79 of 263, 30.0%). A slight increase in the overall mortality from malignancies was observed in diabetic patients and achieved statistical significance in women (observed/expected = 1.16, 95% CI 1.02–1.30; P = 0.019) but not in men (observed/expected = 1.07, 0.97–1.19; P = 0.163). Excess mortality from hepatic cancer (SMR = 1.86, 1.44–2.38) was observed in both men and women. In addition, women with diabetes experienced a higher mortality from pancreatic tumors (observed/expected = 1.78, 1.13–2.67) and breast tumors (observed/expected = 1.40, 1.06–1.81). Excess mortality from breast cancer was confined to obese women with diabetes.
CONCLUSIONS— Mortality from site-specific malignancies is different in type 2 diabetic patients than in the general population. Better control of body weight seems necessary to prevent the excess mortality from breast cancer in women.
Address correspondence and reprint requests to Prof. Michele Muggeo, Endocrinologia e Malattie del Metabolismo, Ospedale Civile Maggiore, Piazzale Stefani 1, 37126 Verona, Italy. E-mail:.
Received for publication 24 September 2002 and accepted in revised form 20 December 2002.
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