The association between diabetes and cancer in Mexico: Analysis using death certificate databases, 2009-2017

Context: Previous studies have shown that diabetes mellitus (DM) is a risk factor of some type-specific cancers. However, no data are available on the association between cancer and DM in Latin America. Aims: The aim of this study is to determine which type-specific cancers are associated with DM using multiple cause of death data. Settings and Design: Whole country of Mexico, cross-sectional design. Materials and Methods: Analysis of all cancer deaths (2009-2017) using death certificate databases of Mexican adults aged >= 20 years. Statistical Analysis Used: Multivariable logistic regression. Results: There were 710,292 total cancer deaths. DM increased the risk of pancreatic (adjusted odds ratio [aOR] = 1.7), liver (aOR = 1.6), kidney (aOR = 1.4), gallbladder (aOR = 1.2) and endometrial (aOR = 1.1) cancers, all P < 0.05. Type 2 or unknown-type DM were associated with the same cancer types with little variation of estimates. Higher estimates were found in males than females (except for kidney cancer). Type 1 DM was associated with pancreatic cancer only (aOR = 1.9). Conclusions: DM in Mexico is associated with gastrointestinal (pancreatic, liver, gallbladder), kidney and endometrial cancers. Dissemination of knowledge to both health-care workers and diabetics regarding potential cancer risks including adequate diet, regular exercise, weight reduction if obese/overweight, cessation of smoking, and good glucose control and medication compliance should be reinforced. Specific cancer preventative measures should be implemented for patients with DM.