Diabetes and cancer: Doubts of a causal link
Menée à partir de données finlandaises portant sur 187 921 témoins et 185 258 personnes souffrant de diabète sucré (durée médiane de suivi : 10,6 ans), cette étude analyse l'association entre la durée d'exposition à la maladie et le risque de cancer (25 899 cas)
A link between diabetes and cancer was noted as early as 1914, but received little attention until the 2000s. Excess body fatness, a key risk factor for type 2 diabetes, is associated with at least 13 obesity-related cancers, namely esophageal adenocarcinoma, gastric cardia, colorectal, liver, gallbladder, pancreatic, post-menopausal breast, endometrial, ovarian, kidney renal-cell, meningioma, thyroid and multiple myeloma.2 With several plausible biological mechanisms, including hyperinsulinemia, it is widely held that excess adiposity is now a common causal factor for cancer. In 2009, against a backdrop of the then new controversy linking long-acting insulin analogues and cancer, a consensus meeting was held under the auspices of the American Diabetes Association, the American Cancer Society, the European Association for the Study of Diabetes and the European Organisation for Oncology. This consensus concluded that “type 2 diabetes is associated with increased risk of several cancer types, including post-menopausal breast, colorectal, endometrial, liver and pancreatic cancers, and non-Hodgkin lymphoma; that these associations seem to be independent of body mass index (BMI); and that in several examples these associations differed from conventional associations between BMI and cancer.” By the start of the 2010s, the prevailing opinion favored a causal link between diabetes and cancer.