Diabetes could increase your risk of head and neck cancer by 50% according to a newly published retrospective cohort study carried out in Taiwan. The research, published in the journal JAMA Otolaryngology looked at data from 89,089 patients with diabetes and found that compared to closely matched people without diabetes they were 47% more likely to develop head and neck cancer.
Neck tumours are an unlikely cause of neck pain but when tumours do develop they may cause similar symptoms to conditions such as cervical spinal stenosis and even temporomandibular joint syndrome. Getting an accurate diagnosis is clearly important in order to access prompt treatment and increase the chance of a successful recovery.
In this latest study, the researchers noted that people with diabetes who were aged 40-65 had a higher risk (57%) of developing head and neck cancer if they had diabetes. Men also had a higher risk (48%) of the condition compared to women.
The researchers obtained the information from Taiwan’s Longitudinal Health Insurance Research Database. This database is reputed to have records from some 23.3 million people, detailing medical benefits paid out between 1996 and December 31, 2011. Dr. Tseng and colleagues matched the patients with controls of the same sex, age and with similar medical conditions (aside from diabetes).
Developing Cancer within 5 Years of Diabetes Diagnosis
The average age of diagnosis with head and neck cancer was 55.52 years for those with diabetes and it took an average of 4.48 years between the patients’ diabetes diagnosis and their cancer diagnosis. Most of the patients with diabetes (57.1%) had a diagnosis of cancer of the mouth, with the second most common site the nasopharynx, which accounted for some 15.3% of cancer diagnoses in the patients with diabetes.
The adjusted hazard ratio (AHR) of oral cancer in those with diabetes was 1.74. For oropharyngeal cancer the AHR was 1.53, and for nasopharyngeal carcinoma the AHR was 1.40.
Diabetes May Increase Risk of Cancer Death
In addition to being less likely to develop head and neck cancer, those without diabetes also had a higher overall survival rate during the study period. This, and the increased incidence of cancer in those with diabetes, could be a result of such things as genetics, epigenetics (i.e. lifestyle, dietary and environmental factors affecting gene expression), and effects related to diabetes itself.
For example, chronically elevated insulin can increase cell proliferation, and chronically elevated blood glucose appears to trigger inflammation and oxidative damage that may influence how cells reproduce, including how DNA is synthesised. As such, new cells created by those with poorly managed diabetes may be more prone to genetic defects and cancerous changes.
The researchers note, however, that there are several overlapping risk factors for head and neck cancer and diabetes. These include alcohol intake, tobacco use and exercise levels. These are also risk factors for neck pain and osteoporosis, which may give people an even greater incentive to quit smoking, moderate alcohol consumption, maintain or begin a healthy exercise regime and to generally improve their health.
Kuo-Shu Tseng, Charlene Lin, Yung-Song Lin, Shih-Feng Weng. (2014). Risk of Head and Neck Cancer in Patients With Diabetes Mellitus: A Retrospective Cohort Study in Taiwan, JAMA Otolaryngol Head Neck Surg. Published online July 24, 2014.