Association of diabetes with survival among cohorts of Indigenous and non-Indigenous Australians with cancer

Jennifer Martin, COORY, Michael, Valery, P. C. and Green. A. C. (2009) Association of diabetes with survival among cohorts of Indigenous and non-Indigenous Australians with cancer. Cancer Causes Control, 20 3: 355-360. doi:10.1007/s10552-008-9249-z


Author Jennifer Martin
COORY, Michael
Valery, P. C.
Green. A. C.
Title Association of diabetes with survival among cohorts of Indigenous and non-Indigenous Australians with cancer
Journal name Cancer Causes Control   Check publisher's open access policy
ISSN 0957-5243
Publication date 2009-01-01
Year available 2008
Sub-type Article (original research)
DOI 10.1007/s10552-008-9249-z
Open Access Status
Volume 20
Issue 3
Start page 355
End page 360
Total pages 6
Place of publication Amsterdam, The Netherlands
Publisher Springer
Language eng
Subject C1
920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes
920104 Diabetes
920102 Cancer and Related Disorders
111299 Oncology and Carcinogenesis not elsewhere classified
111701 Aboriginal and Torres Strait Islander Health
110306 Endocrinology
Abstract Background The association between diabetes and cancer incidence has been well documented, but relatively little research has been undertaken on the potential influence of diabetes on cancer survival and the research that is available has produced inconsistent results. Because Indigenous Australians have a high prevalence of diabetes, we assessed survival, stratified by diabetes, among Indigenous Australian cancer patients. We also assessed survival, stratified by diabetes, amongst a cohort of non-Indigenous Australian cancer patients. Methods All-cause survival and cancer-specific survival in diabetic versus non-diabetic cancer patients were assessed in Indigenous and non-Indigenous cohorts separately, using proportional hazards models. Findings Indigenous cancer patients with diabetes (n = 140) had an overall survival disadvantage compared to Indigenous cancer patients without diabetes (n = 675) with all-cause Hazard Ratio (HR) = 1.4 (95% CI 1.1–1.8) adjusted for age, sex, and cancer site. After further adjustment to take into account the greater number of non-cancer deaths and co-morbidities in Indigenous cancer patients with diabetes, and their later stage at cancer diagnosis with less cancer treatment, there was no residual difference in cancer-specific survival compared to Indigenous cancer patients without diabetes (cancer-specific HR = 1.0, 95% CI 0.8, 1.3). Fewer non-Indigenous cancer patients had diabetes (n = 52) and they showed no differences in survival compared to their counterparts without diabetes. Interpretation The poorer survival of Indigenous Australian cancer patients with diabetes was due to more non-cancer deaths, later stage at cancer diagnosis, less cancer treatment, and more co-morbidities than Indigenous Australian cancer patients without diabetes. In contrast, diabetes did not appear to affect survival in non-Indigenous Australians with cancer, either because there were too few to detect a moderate deleterious effect or because there was no association. Understanding the relation between diabetes and cancer treatment and survival is important because both diabetes and cancer are relatively common diseases, increasingly likely to co-exist.
Keyword Oncology
Public, Environmental & Occupational Health
Oncology
Public, Environmental & Occupational Health
ONCOLOGY
PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SCI
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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Created: Tue, 31 Mar 2009, 23:10:30 EST by Kylie Hengst on behalf of UQ Diamantina Institute