Open Access Highly Accessed Research article

Cancer risks among patients with type 2 diabetes: a 10-year follow-up study of a nationwide population-based cohort in Taiwan

Cheng-Chieh Lin123, Jen-Huai Chiang45, Chia-Ing Li23, Chiu-Shong Liu123, Wen-Yuan Lin12, Teng-Fu Hsieh678 and Tsai-Chung Li49*

Author Affiliations

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

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

3 Department of Medical Research, China Medical University Hospital, Taichung, Taiwan

4 Graduate Institute of Biostatistics, College of Management, China Medical University, 91 Hsueh-Shih Road, Taichung 40421, Taiwan

5 Health Promotion Administration, Ministry of Health and Welfare, Taipei, Taiwan

6 Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan

7 School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan

8 Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan

9 Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan

For all author emails, please log on.

BMC Cancer 2014, 14:381  doi:10.1186/1471-2407-14-381

Published: 29 May 2014



This study aims to determine cancer risks among patients with type 2 diabetes through a follow-up study on a nationwide population-based cohort that included Taiwanese diabetic patients and general population in Taiwan as well as to estimate the population attributable fraction (PAF) of site-specific cancer risks that can be attributed to type 2 diabetes in Taiwanese population by using standardized incidence ratios (SIRs, 95% CI).


Subjects with type 2 diabetes consisted of 472,979 patients aged ≥20 years, whereas general population consisted of 9,411,249 individuals of the same age limit but are not diabetic. Subjects were identified from 1997 to 1998 and followed up until December 31, 2007 or until the first manifestation of any cancer.


Cancer sites with increased risks in men, which were consistent with the main and sensitivity analyses, included pancreas (SIR = 1.62; 95% CI = 1.53 to 1.72), liver (1.61; 1.57 to 1.64), kidney (1.32; 1.25 to 1.40), oral (1.16, 1.12 to 1.21), and colorectal (1.19, 1.15 to 1.22). Cancer sites with increased risks in women included liver (1.55; 1.51 to 1.60), pancreas (1.44; 1.34 to 1.55), kidney (1.38; 1.30 to 1.46), endometrium (1.36; 1.26 to 1.47), bladder (1.19; 1.11 to 1.27), colorectal (1.16; 1.13 to 1.20), and breast (1.14; 1.09 to 1.18). Overall, PAFs were highest for liver cancer in men (4.0%) and women (3.7%), followed by pancreas (3.4%) and kidney (1.6%) cancers in men, and then for endometrium (1.8%) and kidney (1.8%) cancers in women.


Our data suggested that increased cancer risks are associated with type 2 diabetes.

T2DM; Cancer risks; Liver cancer; Colorectal cancer; Pancreas cancer; Breast cancer