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World J Diabetes. Nov 15, 2026; 17(11): 124123
Published online Nov 15, 2026. doi: 10.4239/wjd.124123
Published online Nov 15, 2026. doi: 10.4239/wjd.124123
Diabetes as a pan-cancer risk factor: Triangulated evidence from global burden, longitudinal cohorts, and Mendelian randomization
Ye Lu, Mao-Sheng Chai, Qing-Ying Lan, Qing-Mo Yang, Fu-Rong Yang, Ting-Ning Xiao, Xiao-Wen Kong, Pei-Ru Zhou, Hong Hua, Department of Oral Medicine, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
Co-corresponding authors: Pei-Ru Zhou and Hong Hua.
Author contributions: Lu Y curated the data; Lu Y, Chai MS and Lan QY edited the figure legends; Lu Y, Chai MS, Lan QY, Yang QM, Yang FR, Xiao TN and Kong XW drafted the manuscript; Lu Y, Zhou PR and Hua H prepared the tables and figures; Zhou PR and Hua H revised the manuscript, contributed equally through their joint roles in study conception, design, supervision and critical revision of the manuscript, conceived and designed the study as co-corresponding authors; all authors reviewed and approved the final version of the manuscript.
AI contribution statement: AI tools, specifically ChatGPT, were used solely for language polishing and formatting assistance. No AI tools were used to generate research data, interpret results, or formulate conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Supported by the National Key Research and Development Program of China, No. 2023YFC3605603; the Program of the New Clinical Techniques of Peking University School and Hospital of Stomatology, No. PKUSSNCT-24A10; and the Beijing High-Level Innovative and Entrepreneurship Talent Support Program, Young Backbone Talent Projects, No. G202531217.
Institutional review board statement: Since the Global Burden of Disease database consists of de-identified public data, and the original studies have received ethical approval, no additional ethical review is required for our study.
Informed consent statement: National Health and Nutrition Examination Survey protocols were approved by the Centers for Disease Control and Prevention Ethics Review Board, and all participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: All Global Burden of Disease data are publicly available at the https://vizhub.healthdata.org/gbd-results/. Data from National Health and Nutrition Examination Survey are available at https://wwwn.cdc.gov/nchs/nhanes/Default.aspx. The National Death Index data can be downloaded from https://www.cdc.gov/nchs/ndi. China Health and Retirement Longitudinal Study data can be accessed through http://charls.pku.edu.cn/. All datasets used in this study are publicly available and accessible for download from the respective repositories.
Corresponding author: Hong Hua, MD, PhD, Chief Physician, Professor, Department of Oral Medicine, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, No. 22 Zhongguancun South Street, Haidian District, Beijing 100081, China. honghua1968@aliyun.com
Received: June 8, 2026
Revised: July 29, 2026
Accepted: September 21, 2026
Published online: November 15, 2026
Processing time: 151 Days and 20.6 Hours
Revised: July 29, 2026
Accepted: September 21, 2026
Published online: November 15, 2026
Processing time: 151 Days and 20.6 Hours
Core Tip
Core Tip: Using multiple independent datasets and Mendelian randomization, this study links diabetes to a rising pan-cancer burden, higher cancer prevalence and poorer survival. Longer diabetes duration and higher insulin-resistance markers showed dose-response associations with cancer prevalence, identifying diabetes-related indicators as quantifiable markers of cancer risk. These findings support diabetes-informed cancer risk stratification, targeted prevention and longitudinal sur