Relationship between diabetes mellitus and adenocarcinoma of the oesophagus and gastric cardia


Dr J. H. Rubenstein, VA Medical Center (111-D), 2215 Fuller Road, Ann Arbor, MI 48105, USA.


Background:  Obesity is a risk factor for adenocarcinomas of the oesophagus and gastric cardia. Diabetes mellitus might mediate that association.

Aim:  To estimate the risk of diabetes mellitus on the development of adenocarcinoma of distal oesophagus and gastric cardia beyond that of gastro-oesophageal reflux disease.

Methods:  A case–control study was performed using a national administrative database of the Veterans Administration.

Results:  A total of 311 cases of cancer and 10 154 controls were identified. Gender, age, and race were risks for cancer. Diabetes was diagnosed in 36% of cases, and 32% of controls (P = 0.15). Diabetic complications were diagnosed in 14% of cases and 13% of controls (P = 0.60). Multiple logistic regression confirmed the absence of an association between cancer and diabetes (odds ratio 1.1, 95% confidence interval 0.8–1.5) or diabetic complications (odds ratio 0.8, 95% confidence interval 0.6–1.3), adjusting for age, gender, and race.

Conclusions:  Within the limitations of this case–control study, there is no evidence of an association between diabetes and adenocarcinoma of the oesophagus or gastric cardia among US veterans with gastro-oesophageal reflux disease.