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World J Diabetes. Jun 15, 2020; 11(6): 227-238
Published online Jun 15, 2020. doi: 10.4239/wjd.v11.i6.227
Diabetes and cancer: Epidemiological and biological links
Mina Wang, Yingying Yang, Zehuan Liao
Mina Wang, Zehuan Liao, School of Biological Sciences, Nanyang Technological University, Singapore 637551, Singapore
Mina Wang, The Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China
Mina Wang, Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
Yingying Yang, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna 17177, Sweden
Yingying Yang, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200065, China
Zehuan Liao, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Solna 17177, Sweden
Author contributions: Wang M generated the table and wrote the manuscript; Yang Y contributed to the writing and editing of the manuscript; Liao Z accepted the editor invitation, conceptualized the topic, provided supervision, proofread and edited the manuscript, and approved the submission of this minireview.
Supported by Nanyang Technological University, Singapore, No. G1802358J.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zehuan Liao, BSc, Teaching Assistant, Doctorand, School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551, Singapore. liao0058@e.ntu.edu.sg
Received: January 12, 2020
Peer-review started: January 12, 2020
First decision: January 30, 2020
Revised: April 24, 2020
Accepted: May 5, 2020
Article in press: May 5, 2020
Published online: June 15, 2020
Processing time: 142 Days and 0.8 Hours
Abstract

The incidence of diabetes and cancer has increased significantly in recent years. Furthermore, there are many common risk factors for both diabetes and cancer, such as obesity, sedentary lifestyle, smoking, and ageing. A large body of epidemiological evidence has indicated that diabetes is considered as an independent risk factor for increased rates of heterogeneous types of cancer occurrence and death. The incidence and mortality of various types of cancer, such as pancreas, liver, colorectal, breast, endometrial, and bladder cancers, have a modest growth in diabetics. However, diabetes may work as a protective factor for prostate cancer. Although the underlying biological mechanisms have not been totally understood, studies have validated that insulin/insulin-like growth factor (IGF) axis (including insulin resistance, hyperinsulinemia, and IGF), hyperglycemia, inflammatory cytokines, and sex hormones provide good circumstances for cancer cell proliferation and metastasis. Insulin/IGF axis activates several metabolic and mitogenic signaling pathways; hyperglycemia provides energy for cancer cell growth; inflammatory cytokines influence cancer cell apoptosis. Thus, these three factors affect all types of cancer, while sex hormones only play important roles in breast cancer, endometrial cancer, and prostate cancer. This minireview consolidates and discusses the epidemiological and biological links between diabetes and various types of cancer.

Keywords: Diabetes; Cancer; Insulin/Insulin-like growth factor axis; Hyperglycemia; Sex hormones; Biomarkers

Core tip: The incidence of diabetes and cancer has increased significantly in recent years. The incidence and mortality of various types of cancer, such as pancreas, liver, colorectal, breast, endometrial, and bladder cancers, have a modest growth in diabetics. However, diabetes may work as a protective factor for prostate cancer. This minireview consolidates and discusses the epidemiological and biological links between diabetes and various types of cancer.