Incidence of cancer among diabetic and non-diabetic adult Israeli Arabs.

BACKGROUND A worldwide epidemic of type 2 diabetes mellitus (T2DM) is in progress. This disease carries a heavy socioeconomic burden. OBJECTIVES To compare the incidence rate of overall and site-specific cancers among Israeli Arabs with T2DM to that of Israeli Arabs without. METHODS A retrospective cohort study of all adult Arab members of Clalit Health Care Services in northern Israel was conducted over a 10 year period (1999-2008). RESULTS During the study period 752 and 2045 incident cases of cancer were diagnosed among 13,450 adults with diabetes and 74,484 without, respectively. The follow-up time involved 817,506 person-years. Diabetes was associated with a standard incidence ratio (SIR) of 3.27 (95% CI 1.49-5.05) and 2.87 (95% CI 1.25-4.50) for pancreatic cancer in men and women, respectively. A significantly reduced SIR (0.67, 95% CI 0.36-0.99) was observed for esophageal, stomach and intestinal cancers in men. CONCLUSIONS Our findings support an association between T2DM and increased risk of cancer of the pancreas in Arab men and women. A significantly reduced risk of all other cancers was observed only in Arab men. Our findings underscore the need for effective diabetes and cancer prevention and intervention programs.