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Type 2 diabetes mellitus and risk of head and neck cancer subtypes: a systematic review and meta-analysis of observational studies

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Abstract

Aims

The association between type 2 diabetes mellitus (T2DM) and risk of head and neck cancer (HNC) remains unclear. This study aims to perform a system review and meta-analysis to explore this relationship.

Methods

PubMed, Web of Science, and Embase databases were searched for studies published up to July 31, 2020, regarding the association between T2DM and HNC risk. A random-effects model was utilized to calculate summary relative risks (RRs) with corresponding 95% confidence intervals (CIs).

Results

Fourteen case–control studies and thirteen cohort studies were included in our analysis. We observed a weak association between T2DM and risk of HNC overall, but there was no statistical significance (RR, 1.04; 95% CI, 0.88–1.23; I2 = 83.2%). Interestingly, there was a strong association in East Asia (RR, 1.46; 95% CI, 1.21-1.77; I2 = 36.6%). For HNC subtypes, T2DM conferred a significantly elevated risk in oral cancer (RR, 1.22; 95% CI, 1.01–1.47; I2 = 89.0%). However, in subgroup analyses of smoking, alcohol use, and body mass index (BMI)/obesity adjustments, the association between T2DM and oral cancer risk became insignificant. In addition, T2DM was not associated with a statistically elevated risk of pharyngeal cancer (RR, 1.18; 95% CI, 0.94–1.49; I2 = 72.9%) and laryngeal cancer (RR, 1.03; 95% CI, 0.88–1.22; I2 = 71.2%).

Conclusions

This meta-analysis indicates that T2DM is associated with an increased risk of HNC in East Asia. As for site-specific cancer types, the risk of oral cancer was significantly increased in T2DM patients, which appear to be mediated or confounded by smoking, alcohol use, or BMI/obesity.

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Authors and Affiliations

  1. Department of Preventive Medicine, School of Health Sciences, Wuhan University, No. 185 Donghu Road, Wuhan, 430071, China

    Pengfei Yan, Yongbo Wang, Xue Yu & Zhi-Jiang Zhang

  2. Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China

    Yongbo Wang

  3. Department of Statistics and Management, School of Management, Wuhan Institute of Technology, Wuhan, 430205, China

    Yu Liu

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  4. Yu Liu
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  5. Zhi-Jiang Zhang
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Contributions

The author contributions were as follows: ZJZ supervised the analysis and interpretation of data and revised the manuscript. YPF,WYB, and YX searched literature, selected topics, collected data, drafted and revised the manuscript. LY proofread data and revised the manuscript. All authors contributed to the discussion of the results. All authors read and approved the final version of the manuscript.

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Correspondence to Zhi-Jiang Zhang.

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Yan, P., Wang, Y., Yu, X. et al. Type 2 diabetes mellitus and risk of head and neck cancer subtypes: a systematic review and meta-analysis of observational studies. Acta Diabetol 58, 549–565 (2021). https://doi.org/10.1007/s00592-020-01643-0

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