Many studies have suggested that diabetes mellitus type 2 may alter the risk of developing a variety of cancers, and the associations are biologically plausible. One of largest prospective studies worldwide, enrolling 467,922 men and 588,321 women who had no reported history of cancer at the time of enrollment, revealed after 16 years of follow-up that diabetes was significantly associated with fatal colon cancer in men and women, and with PC in men, and significantly associated with liver cancer and bladder cancer. In addition, diabetes was significantly associated with breast cancer in women . These findings strongly suggest that diabetes is an independent predictor of mortality from these cancer entities.
When treating cancer patients who have diabetes, clinicians must consider the cardiac, renal, and neurologic complications commonly associated with diabetes; continued improvement of cancer outcomes may also depend upon improved diabetes control .
Diabetes rates continue to skyrocket - nearly 21 million people in the USA are afflicted by diabetes and roughly 250 million worldwide. Health analysts project that by 2025, 50 million Americans and up to 380 million globally will have diabetes. The International Diabetes Federation, which tracks global diabetes, says the disease will cause 3.8 million deaths worldwide in 2007, about equal to HIV/AIDS and malaria combined. In the USA, the Centers for Disease Control and Prevention state that diabetes is the sixth leading cause of death, contributing to nearly 225,000 deaths in 2002, up from 213,064 in 2000 - there is a 'growing tsunami of diabetes.
Considering the numerous results of epidemiologic and clinical studies involving diabetes mellitus and malignancies, clinicians must also consider the increased risk of new-onset and longstanding diabetics for some tumor entities by regularly screening diabetic patients for early development of tumors.
The association between diabetes and cancer is complex and warrants further and differentiating types of clinical studies - from molecular epidemiology to clinical interventions. The general population ages and the magnitude of both health problems continues to grow. As one consequence, scientists, clinicians and politicians have to develop national policies for early diagnosis and prevention of diabetes melli-tus and cancer more effectively, otherwise both diseases and their biologic and socio-logic relationships could likely overwhelm health systems.
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