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Impaired glucose tolerance linked to increased risk of cancer mortality

Last Updated: 2003-07-17 10:41:29 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In the United States, impaired glucose tolerance is predictive of cancer mortality -- especially colon cancer -- according to a report in the July 1st issue of the American Journal of Epidemiology.

"Although abnormal glucose tolerance is a well-established risk factor for cardiovascular disease, its relation to cancer risk is less certain," Dr. Sharon H. Saydah, of Social and Scientific Systems, Inc., Silver Spring, Maryland, and colleagues note. To investigate, the team prospectively examined data from the Second National Health and Nutrition Examination Survey.

Included in the study were 3054 adults between the ages of 30 and 74 years who had an oral glucose tolerance test at baseline (1976 to 1980). Participants were classified as having previously diagnosed diabetes (n = 247), undiagnosed diabetes (n = 180), impaired glucose tolerance (n = 447), or normal glucose tolerance (n = 2250).

The researchers identified deaths by searching national mortality files through 1992 and found there were 206 cancer deaths during follow-up.

"The highest death rate per 1000 person-years was for the impaired glucose tolerance group at 8.1, followed by undiagnosed diabetes at 5.7, diagnosed diabetes at 5.4, an the normal glucose tolerance group at 4.1," Dr. Saydah and colleagues report.

On analysis, subjects with impaired glucose tolerance had the greatest adjusted relative hazard of cancer mortality (relative hazard = 1.87) compared to those with normal glucose tolerance.

The investigator note that the most commonly reported cancer sites were the lung, colon, pancreas, breast, and prostate. Patients with impaired glucose tolerance had a relative risk of colon cancer that was 4.24 times higher than those with normal glucose tolerance.

The investigators infer that patients with impaired glucose tolerance should be targeted for participation in colon cancer screening programs.

Am J Epidemiol 2003; 157:1092-1100.

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