糖尿病患者患各种癌症的风险显着较高，并且这两种疾病之间的潜在生物学联系尚未完全了解。这是一项纵向回顾性全国队列研究，该研究设计使我们能够检查癌症的自然病程。大样本量的长期癌症发展。最初，分别对 3,111,975 名和 22,208,395 名年龄≥20 岁的患有糖尿病和未患糖尿病的符合条件的患者进行了年龄、性别和查尔森合并症指数的匹配。最终，每组共选出 1,751,457 名患者。对糖尿病视网膜病变 (DR) (n = 380,822) 和无 DR (n = 380,822) 以及增殖性 DR (PDR) (n = 141,150) 和非增殖性 DR (NPDR) (n = 141,150) 的分层人群进行了分析这项研究。主要结果指标是随访期间首次诊断出癌症。我们观察到癌症总发病率增加了 20% [风险比 (HR)，1.20；与非糖尿病队列相比，糖尿病队列中的 p<<0.001]。肝癌和胰腺癌的 HR 最高。口腔癌、结肠癌、胆囊癌、生殖癌（女性）、肾癌和脑癌的风险适度增加。此外，患胃癌、皮肤癌、软组织癌、女性乳腺癌、尿路癌（肾癌除外）以及淋巴癌和造血系统恶性肿瘤的风险显着增加。分层分析显示，与非 DR 队列相比，DR 队列中的总癌症发病率显着较高（HR，1.31；p< 0.001），并且与 NPDR 队列相比，PDR 队列中的风险略有增加（ HR, 1.13；p = 0.001）。这项研究提供了大规模、全国性、基于人群的证据，表明糖尿病与随后发生总癌症和特定部位癌症的风险增加独立相关。值得注意的是，当 DR 发展时，这种风险可能会进一步增加。© 2024。作者。

Individuals with diabetes have a significantly higher risk of developing various forms of cancer, and the potential biological links between these two diseases are not completely understood.This was a longitudinal retrospective nationwide cohort study, a study design that allows us to examine the natural course of cancer development over an extended period of time with a large sample size. Initially, 3,111,975 and 22,208,395 eligible patients aged ≥ 20 years with and without diabetes, respectively, were matched by age, sex, and the Charlson comorbidity index. Ultimately, 1,751,457 patients were selected from each group. Stratified populations for diabetic retinopathy (DR) (n = 380,822) and without DR (n = 380,822) as well as proliferative DR (PDR) (n = 141,150) and non-proliferative DR (NPDR) (n = 141,150) were analyzed in this study. The main outcome measure was the first-time diagnosis of cancer during the follow-up period.We observed a 20% higher risk of total cancer incidence [hazard ratios (HR), 1.20; p < 0.001] in the diabetes cohort compared to the non-diabetes cohort. The highest HR was observed for liver and pancreas cancers. Moderately increased risks were observed for oral, colon, gallbladder, reproductive (female), kidney, and brain cancer. Furthermore, there was a borderline significantly increased risk of stomach, skin, soft tissue, female breast, and urinary tract (except kidney) cancers and lymphatic and hematopoietic malignancies. The stratified analysis revealed that the total cancer incidence was significantly higher in the DR cohort compared to the non-DR cohort (HR, 1.31; p < 0.001), and there was a borderline increased risk in the PDR cohort compared to the NPDR cohort (HR, 1.13; p = 0.001).This study provides large-scale, nationwide, population-based evidence that diabetes is independently associated with an increased risk of subsequent development of total cancer and cancer at specific sites. Notably, this risk may further increase when DR develops.© 2024. The Author(s).