Association of risk factors in terms of diet, lifestyle, genetic susceptibility, metabolic disorder and treatment with the comorbidity of diabetes with cancer.

Aims: this project aimed to identify the specific risk factors related to the comorbidity of diabetes and different types of cancer, to reveal their internal causal relationship and potential common mechanism based on plasma metabolites and genetics, and to establish the accurate evaluation model for cancer risk among diabetes for providing the personalized diabetes-cancer prevention and treatment strategies.
Scientific rationale: Previous cohort studies observed that cancer and diabetes was frequently coexisted. However, the association of diabetes and different types of cancer was heterogeneous, which was likely mediated by life-styles, diet, sex, genetics and micro-environment of hormonal and metabolic ability among different population. The previous evidence suggested that cancer and diabetes shared common mechanisms, such as inflammation, hyperinsulinemia, hyperglycemia, dysfunction of amino acids and fatty acids metabolism. Also, there are many studies have demonstrated that dietary risk factors, medication for diabetes or caner, and genetic risk factors could influence these above mechanisms. Based on these evidences, we hypothesized that susceptibility genes, physiological and pathological states, drug use could mediate the association of diabetes and different types of cancer, and elucidating these unravelling questions may added important knowledge for the intervention strategies for diabetes and cancer.
Project duration and public health impact: this project duration is estimated for 3 years. More than 60% of countries citing cancer as the top 1-2 cause of human death, which seriously threatens public health. Over 1/4 of people gets cancer during the lifetime, and over 17% of cancer patients have diabetes or abnormally plasma glucose. Previous studies reported that up to 10 types of cancer were attributed to obesity, hyperglycemia, and diabetes. Epidemiological studies showed that people with diabetes had a higher prevalence of malignant tumors, greater cancer process, poor treatment effect, and shortened survival time. Each 1% increase in the prevalence of diabetes was associated with 19% increase in the mortality rate of pancreatic cancer. According to a study in the Lancet, the per capita treatment cost for common cancers such as lung cancer and stomach cancer, is approximately $10,000 per year. Therefore, it is important to elucidate the potential risk factors for the cancer among patients with diabetes, which may improve the long-term survival among diabetes by providing evidence in terms of the prevention and treatment to reduce social financial burden on healthcare.