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Open Access Research article

Risk of esophagus cancer in diabetes mellitus: a population-based case-control study in Taiwan

Kao-Chi Cheng1, Yu-Lung Chen1, Shih-Wei Lai12, Pang-Yao Tsai34 and Fung-Chang Sung34*

Author Affiliations

1 Department of Family Medicine, China Medical University Hospital, Taichung, 404, Taiwan

2 School of Medicine, China Medical University, Taichung, 404, Taiwan

3 Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan

4 Department of Public Health, China Medical University, Taichung, 404, Taiwan

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BMC Gastroenterology 2012, 12:177  doi:10.1186/1471-230X-12-177

Published: 12 December 2012

Abstract

Background

Diabetes mellitus (DM) has been associated with the cancer risk. This study investigated relationship between DM and esophageal cancer using Taiwan’s insurance data.

Methods

We identified 549 patients with esophageal cancer newly diagnosed in 2000-2009 and randomly selected 2196 controls without any cancer, frequency matched by sex, age and diagnosis year of cases. Logistic regression model estimated odds ratios (ORs) and 95% confidence intervals (CI) of esophageal cancer associated with DM, sex, age. co-morbidities and medications.

Results

Cases were more prevalent than controls for alcoholism and esophageal disorders and using nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 inhibitors but not DM. Esophageal cancer had no association with DM (OR 0.99, 95% CI 0.71-1.37), but significantly associated with alcoholism (OR 14.1, 95% CI 7.87-25.4), esophageal ulcer (OR 10.1, 95% CI 5.70-17.9), esophageal reflux (OR 3.47, 95% CI 2.14-5.26) and uses of NSAIDs (OR 2.73, 95% CI 1.80-4.13). An elevated risk of esophageal cancer appeared in DM patients taking insulin (OR 2.57, 95% CI 1.08-6.15) or sulfonyurea (OR 3.80, 95% CI 1.16-12.5).

Conclusions

Patients with DM are not at higher risk for esophagus cancer. However, esophageal disorders and anti-diabetic drugs are associated with the risk of the disease.

Keywords:
Case-control study; Diabetes; Esophagus cancer; Insulin