New-Onset T2D Tied to Higher Risk of Obesity-Related Cancer: Daily Dose

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On April 24, 2025, we reported on findings from a new study presented at the 2025 European Congress on Obesity (ECO), held May 11-14 in Malaga, Spain, that investigated the relationship between new-onset type 2 diabetes (T2D) and obesity-related cancers (ORCs).

The study

Researchers conducted a matched cohort control study within UK Biobank of new-onset T2D (defined by date of first reported non-insulin dependent diabetes) compared to unexposed individuals matched (1 participant to 3 controls) on body mass index (BMI), age, and sex. They collected cases of 13 types of obesity-related cancers among the study groups. Adults were followed for a median of 5 years. The primary outcome was the incidence of ORCs, including liver, pancreatic, bowel, endometrial, postmenopausal breast, and others. To reduce bias, the analysis excluded individuals with prevalent diabetes and accounted for potential confounders such as smoking, alcohol consumption, and the increased likelihood of cancer diagnoses shortly after a diabetes diagnosis due to heightened medical surveillance.

There were 23 750 adults with T2D matched with 71 123 adults without T2D. Incident obesity-related cancers occurred in 2431 adults with T2D and 5184 controls.

The findings

Investigators observed that men with T2D had increased risk for obesity-related cancers compared with those without T2D (HR = 1.48; 95% CI, 1.29-1.7; P < .001). Men with T2D had higher risk for hepatocellular carcinoma (HR = 3.59; 95% CI, 2.23-5.77; P < .001), pancreatic cancer (HR = 1.74; 95% CI, 1.14-2.64; P < .01), colorectal cancer (HR = 1.27; 95% CI, 1.02-1.57; P < .05) and kidney cancer (HR = 1.53; 95% CI, 1.08-2.17; P < .05) than men without T2D.

Women with new-onset T2D had increased risk for any obesity-related cancer (HR = 1.24; 95% CI, 1.08-1.42; P < .01), pancreatic cancer (HR = 2.1; 95% CI, 1.27-3.49; P < .01), hepatocellular carcinoma (HR = 4.82; 95% CI, 1.06-21.86; P < .05), thyroid cancer (HR = 2.51; 95% CI, 1.12-5.62; P < .05) and esophageal adenocarcinoma (HR = 6.34; 95% CI, 1.48-27.13; P < .05) compared with women without T2D.

Authors' comments

"Having accounted for key biases found in previous research in this field, and confounding (by adjusting for BMI, smoking, alcohol, and detection-time bias), our findings indicate that new-onset T2DM is associated with some but not all site-specific obesity-related cancers. In turn, the pathways through which T2DM may affect obesity-related cancer require further investigation."

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