Epidemiology in older adults of the comorbidity of type 2 diabetes and cancer

Abstract

Clinical and epidemiological evidence shows associations between cancer and type 2 diabetes mellitus (DM2). These diseases share some common pathophysiological mechanisms. Aim: To study in a population of older adults whether the presence of DM2 affects the epidemiological parameters of cancer.

Retrospective observational epidemiological study (2006-2017), analysis of 4,574 medical records of patients (≥65 years), Centro San Ricardo Pampuri (Va. Carlos Paz, Córdoba). Cancer patients were grouped: with DM2 and without DM2. The following were calculated and compared: prevalence, mortality, lethality and survival for each group. Data were analyzed with Infostat using ANOVA (continuous variables) and chi-square (categorical), p≤0.05. Confidentiality and anonymity were respected.

Population data: 56% women/44% men. 42% of the total population suffered from obesity and 39.8% DM2. 390 cancer patients in the period. General cancer prevalence=8.5%, mortality=27.5 ‰, lethality=32%. Average survival: 2544.44 days. Prevalences between patients with and without DM2, and between the sexes were similar, but higher in obese patients (58 vs 42%). Most frequent tumors: female: breast (0.44) and colon (0.10); male: prostate (0.36) and colon (0.17). Comparisons between patients with and without DM2: -Prevalence (‰): -Older in the group with DM2: Men: pancreas (1.31vs0.44), kidney (1.31vs0.44) and non-Hodgkin lymphoma (0.87vs0.44); Women: breast (11.15vs8.31), pancreas (1.75vs0) and endometrium (1.53vs0.87). -Higher in the group without DM2: Men: prostate (7vs4.37), colon (3.28vs2.84) and bladder (1.97vs0.87); Women: colon (3.06vs1.31), thyroid (1.09vs0.44) and melanoma (1.09vs0.22). –Age at diagnosis (years): colon cancer (68.91vs75.87) and prostate cancer (71.78vs77.74) were found at earlier ages in men with DM2. –Mortality: The values were similar in women with and without DM2 (RR:1.01; OR:1.02). In men it was lower for DM2 (RR:0.74; OR:0.57). Those with the highest mortality in patients with DM2 were: breast>colon>prostate>pancreas. –Lethality (%): higher in DM2 patients for gastric cancer (100vs50), while esophagus, colon, kidney and prostate were higher in the group without DM2. –Survival (days): women without DM2 have a higher survival (4213.5vs1802.73).

The existence of DM2 in comorbidity with cancer significantly affects the parameters studied, mainly in women, since breast cancer had a higher prevalence in women with DM2, and these had a lower survival.