Relationship between HbA(1c) and cancer in people with or without diabetes: a systematic review

Hope, C., Robertshaw, A., Cheung, K. L., Idris, I. and English, E. ORCID: (2016) Relationship between HbA(1c) and cancer in people with or without diabetes: a systematic review. Diabetic Medicine, 33 (8). pp. 1013-1025. ISSN 0742-3071

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Aim: To identify the relationship between HbA1c and cancers in people with or without diabetes. Background: Cancer is a major public health problem, accounting for 8.2 million deaths worldwide in 2012. HbA1c level has been associated with the risk of developing certain cancers, although the existing evidence is conflicting. Methods: EMBASE, MEDLINE, CINAHL and the Cochrane Library were searched. Eligible articles included randomized controlled trials, cohort studies, case–control studies, systematic reviews and meta-analyses. Participants of either sex, with or without Type 1 or 2 diabetes, were included. The studies were assessed using the Scottish Intercollegiate Guidelines Network (SIGN) criteria by two independent assessors. No meta-analysis was performed because of the heterogeneity of results. Results: A total of 19 studies from 1006 met the inclusion criteria, of which 14 were cohort studies and five were nested case–control studies. Eight studies investigated outcomes for all cancer sites. Four of these studies reported that higher HbA1c levels were associated with higher incidence and/or mortality risk for all cancers. One study observed a U-shaped relationship between HbA1c and cancer incidence and mortality. Increasing HbA1c levels were associated with increasing risk of developing colorectal, pancreatic, respiratory and female genital tract cancers. No increased risk was observed for breast cancer, gastrointestinal or urological malignancies. Conclusion: HbA1c appears to be associated with cancer incidence and/or cancer mortality, but further studies are needed to fully understand the complex relationship between HbA1c and cancer.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: C. Hope, A. Robertshaw, K. L. Cheung, I. Idris, E. English, Diabet. Med. 33, 1013–1025 (2016), which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Depositing User: Pure Connector
Date Deposited: 22 Mar 2016 09:22
Last Modified: 22 Oct 2022 00:41
DOI: 10.1111/dme.13031

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