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Oral cancer in Taiwan: is diabetes a risk factor?

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Abstract

Objectives

The association between diabetes and oral cancer is rarely studied. We investigated the trends of oral cancer in the Taiwanese general population and the possible link with diabetes.

Materials and methods

The trend of age-standardized oral cancer incidence in 1979–2007 in Taiwan was calculated from the Taiwan Cancer Registry database. A total of 494,817 men and 503,723 women without oral cancer from a random sample of 1,000,000 individuals covered by the National Health Insurance were followed up from 2003 to 2005. Cox regression evaluated the adjusted relative risk considering potential detection bias and covariates.

Results

The trends increased significantly in both sexes. Diabetic patients had a higher chance of oral cancer detection because they more frequently visited related medical professionals. Although diabetes status and duration were significantly associated with oral cancer in unadjusted models, none was significant after multivariable adjustment. For comorbidities, chronic obstructive pulmonary disease (a surrogate for smoking) and alcohol-related diagnoses were significant for men, and hypertension and alcohol-related diagnoses were significant for women. Additionally, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and insulin were significant with relative risk (95 % confidence interval) of 1.642 (1.174–2.295) and 2.136 (1.003–4.547), respectively, in men.

Conclusions

Oral cancer is increasing in Taiwan. Diabetes is not a risk factor after multivariable adjustment.

Clinical relevance

The increasing trend of oral cancer may not be ascribed to diabetes. The association between oral cancer and some comorbidities and medications requires confirmation and may provide strategies for the prevention of oral cancer.

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References

  1. Meurman JH (2010) Infectious and dietary risk factors of oral cancer. Oral Oncol 46:411–413

    Article  PubMed  Google Scholar 

  2. Fitzpatrick SG, Katz J (2010) The association between periodontal disease and cancer: a review of the literature. J Dent 38:83–95

    Article  PubMed  Google Scholar 

  3. Nugent Z (2010) Periodontal disease may be associated with oral and gastrointestinal cancer. J Evid Based Dent Pract 10:223–224

    Article  PubMed  Google Scholar 

  4. Purohit V, Khalsa J, Serrano J (2005) Mechanisms of alcohol-associated cancers: introduction and summary of the symposium. Alcohol 35:155–160

    Article  PubMed  Google Scholar 

  5. Bureau of Health Promotion, Department of Health (2007) The Executive Yuan, Taiwan. Cancer Registry Annual Report, Taiwan

  6. Su CC, Tsai KY, Hsu YY, Lin YY, IeB L (2010) Chronic exposure to heavy metals and risk of oral cancer in Taiwanese males. Oral Oncol 46:586–590

    Article  PubMed  Google Scholar 

  7. Yuan TH, IeB L, Tsai KY, Chang TK, Chiang CT, Su CC et al (2011) Possible association between nickel and chromium and oral cancer: a case-control study in central Taiwan. Sci Total Environ 409:1046–1052

    Article  PubMed  Google Scholar 

  8. Chiang CT, Hwang YH, Su CC, Tsai KY, IeB L, Yuan TH (2010) Elucidating the underlying causes of oral cancer through spatial clustering in high-risk areas of Taiwan with a distinct gender ratio of incidence. Geospat Health 4:230–242

    PubMed  Google Scholar 

  9. Muoio DM, Newgard CB (2008) Mechanisms of disease: molecular and metabolic mechanisms of insulin resistance and beta-cell failure in type 2 diabetes. Nat Rev Mol Cell Biol 9:193–205

    Article  PubMed  Google Scholar 

  10. Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA et al (2010) Diabetes and cancer: a consensus report. Diabetes Care 33:1674–1685

    Article  PubMed  Google Scholar 

  11. Tseng CH, Chong CK, Tai TY (2009) Secular trend for mortality from breast cancer and the association between diabetes and breast cancer in Taiwan between 1995 and 2006. Diabetologia 52:240–246

    Article  PubMed  Google Scholar 

  12. Tseng CH, Chong CK, Tseng CP, Chan TT (2009) Age-related risk of mortality from bladder cancer in diabetic patients: a 12-year follow-up of a national cohort in Taiwan. Ann Med 41:371–379

    Article  PubMed  Google Scholar 

  13. Tseng CH (2011) Diabetes and risk of bladder cancer: a study using the National Health Insurance database in Taiwan. Diabetologia 54:2009–2015

    Article  PubMed  Google Scholar 

  14. Ujpál M, Matos O, Bíbok G, Somogyi A, Szabó G, Suba Z (2004) Diabetes and oral tumors in Hungary: epidemiological correlations. Diabetes Care 27:770–774

    Article  PubMed  Google Scholar 

  15. Atchison EA, Gridley G, Carreon JD, Leitzmann MF, McGlynn KA (2011) Risk of cancer in a large cohort of U.S. veterans with diabetes. Int J Cancer 128:635–643

    Article  PubMed  Google Scholar 

  16. Taiwan Cancer Registry (2010). http://tcr.cph.ntu.edu.tw/uploadimages/Year_Male%20genital.xls. Accessed 20 July 2010

  17. Tseng CH, Tseng CP, Chong CK, Huang TP, Song YM, Chou CW et al (2006) Increasing incidence of diagnosed type 2 diabetes in Taiwan: analysis of data from a national cohort. Diabetologia 49:1755–1760

    Article  PubMed  Google Scholar 

  18. Tseng CH (2009) The epidemiologic transition of diabetes mellitus in Taiwan: implications for reversal of female preponderance from a national cohort. Open Diabetes J 2:18–23

    Article  Google Scholar 

  19. Yang MS, Su IH, Wen JK, Ko YC (1996) Prevalence and related risk factors of betel quid chewing by adolescent students in southern Taiwan. J Oral Pathol Med 25:69–71

    Article  PubMed  Google Scholar 

  20. Wang SC, Tsai CC, Huang ST, Hong YJ (2003) Betel nut chewing and related factors in adolescent students in Taiwan. Publ Health 117:339–345

    Article  Google Scholar 

  21. Tseng CH (2008) Betel nut chewing is associated with hypertension in Taiwanese type 2 diabetic patients. Hypertens Res 31:417–423

    Article  PubMed  Google Scholar 

  22. Lin WY, Pi-Sunyer FX, Liu CS, Li TC, Li CI, Huang CY et al (2009) Betel nut chewing is strongly associated with general and central obesity in Chinese male middle-aged adults. Obesity 17:1247–1254

    PubMed  Google Scholar 

  23. Tseng CH (2010) Betel nut chewing and incidence of newly diagnosed type 2 diabetes mellitus in Taiwan. BMC Res Notes 3:228

    Article  PubMed  Google Scholar 

  24. Tseng CH (2006) Betel nut chewing is independently associated with urinary albumin excretion rate in type 2 diabetic patients. Diabetes Care 29:462–463

    Article  PubMed  Google Scholar 

  25. Tseng CH (2010) Betel nut chewing and subclinical ischemic heart disease in diabetic patients. Cardiol Res Pract 2011:451489

    PubMed  Google Scholar 

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Acknowledgments

The study was based on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes (registered number 99274). The interpretation and conclusions contained herein do not represent those of Bureau of National Health Insurance, Department of Health or National Health Research Institutes.

Conflict of interest

The author declares that there is no duality of interest associated with this manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, 100, Taiwan

    Chin-Hsiao Tseng

  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Chin-Hsiao Tseng

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  1. Chin-Hsiao Tseng
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Correspondence to Chin-Hsiao Tseng.

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Tseng, CH. Oral cancer in Taiwan: is diabetes a risk factor?. Clin Oral Invest 17, 1357–1364 (2013). https://doi.org/10.1007/s00784-012-0820-3

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  • DOI: https://doi.org/10.1007/s00784-012-0820-3

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