Higher risk of mortality from lung cancer in Taiwanese people with diabetes

Background: The association between diabetes and lung cancer is rarely studied in the Asian populations. This study investigated lung cancer mortality trends, mortality rate ratios between people with diabetes and the general population, and associated risk factors in people with diabetes in Taiwan. Methods: Age-standardized trends from 1995 to 2006 were evaluated, followed by calculation of age-sex-specific average mortality rates within the 12-year period in the general population. A total of 113,347 men and 131,573 women with diabetes, aged >= 25 years and recruited in 1995-1998 were followed to 2006. Age-sex-specific mortality rate ratios between people with diabetes and the general population were calculated. Cox regression evaluated the risk factors in the people with diabetes. Results: A steady age-standardized trend was observed for either sex. A total of 1580 men and 931 women with diabetes died of lung cancer. Mortality rate ratios showed a significantly higher risk in patients with diabetes: 1.16 (1.04-1.30), 1.42 (1.33-1.53), 1.79 (1.61-1.99) and 4.37 (3.75-5.09) for >= 75, 65-74, 55-64 and 25-54 years old, respectively, for men; and 1.35 (1.18-1.54), 1.41 (1.27-1.57), 1.88 (1.66-2.13) and 3.57 (2.95-4.33), respectively, for women. Age and smoking were significantly associated with lung cancer mortality in the people with diabetes, but sex, diabetes type and insulin use were not. Diabetes duration was significant when those who died of lung cancer within 5 years of diabetes diagnosis were excluded from analysis. Conclusions: People with diabetes have a higher risk of lung cancer mortality and this was most remarkable in the youngest age. (C) 2013 Elsevier Ireland Ltd. All rights reserved.