Higher Prevalence of Prostate Cancer among Veterans with Type 2 Diabetes

Background: Diabetes mellitus and cancer are common conditions. Based on epidemiological evidence, American Diabetes Association (ADA) and the American Cancer Society (ACS) concluded that patients with diabetes are at a higher risk for cancers in their joint position statement. That statement includes a meaningful association between cancer and diabetes; common risk factors for both; possible biological links between the two and also whether the diabetes therapy alters risk or prognosis of cancer. Additional comments included lack of association or evidence between diabetes and cancers such as lung cancer and lymphomas; and reduced risk of prostate cancer among subjects with type 2 diabetes. It was also stated that some cancers such as liver, pancreas, colon and rectum, breast, bladder and endometrial cancers. Since prevalence of diabetes is more than 25% among Veterans, our aim of this study was to evaluate the prevalence of various cancers among Veterans with type 2 diabetes at Albany, NY. Methods: In a single center, retrospective chart review study was carried out using computerized patient records, after the Institutional Review Board and Research and development review board at Veterans health administration at Stratton VA MC at Albany, New York. Using CPT codes and verification by review of clinical and laboratory information, the study was carried out. The information collected include the BMI, smoking status, duration of diabetes, medications used, other medical problems such as hypertension, atherosclerotic cardiovascular disease, various cancers; laboratory data included HbA1C, eGFR, Creatinine and lipid parameters. Results: The study identified 6777 subjects with type 2 diabetes with a mean age of 61 ± 10 and BMI of 32.6 ± 6. Total of 1046 subjects identified with cancers, after exclusion of skin cancers. The most common cancers among Veterans with type 2 DM are prostate cancer, colon cancer, bladder cancer and Lung Cancer. Other cancers include renal cell cancer, liver cancer, pancreatic cancer, lymphomas and breast cancer. Conclusion: It is worth considering the causes why prostate and bladder cancers are so common among subjects with diabetes using national database.