February 12, 2017
A recent study conducted by researchers in the UNC Gillings School of Global Public Health suggests that ovarian cancer patients who also have diabetes mellitus (DM) have higher mortality rates than those without DM.
The study, published online on Dec. 6, 2016, in the journal Diabetes/Metabolism Research and Reviews, found that women with ovarian cancer and DM are 40 percent to 50 percent more likely to die from all causes, as well as specifically from cancer, than are ovarian cancer patients without DM.
Dongyu Zhang, ScM, MD, epidemiology doctoral student at the Gillings School, is the study’s first author.
The relative five-year survival rate for ovarian cancer, the sixth most common cancer among women, is lower than 50 percent. Chronic diseases, including DM, may be a factor in this unfavorable prognosis. By affecting the levels of blood glucose and concentrations of insulin, DM can impact the homeostasis of the human body, which may cause serious complications including diabetic ketoacidosis and diabetic retinopathy. More severely, the disease may affect the prognosis of other comorbidities. In particular, some evidence suggests that DM can have a negative influence upon the survival of cancer patients.
Given that few epidemiological studies have investigated the association between DM and ovarian cancer mortality – and that the conclusions of existing studies are inconsistent – the researchers synthesized available epidemiologic evidence to obtain conclusions regarding the effect of DM on the mortality of ovarian cancer patients.
In March 2016, the researchers conducted a literature search of four electronic databases – PubMed, EMBASE, Web of Science and SCOPUS – and located studies about the DM/ovarian cancer connection that fit the researchers’ rigorous criteria. They identified 12 studies to use in their research, which included geographic diversity, featuring the U.S., Europe and Asia; different eras, ranging from 1961 to 2012; and different study settings, including population- and clinic-based.
The health implications of this study are notable. Since diabetes mellitus and insulin resistance may affect the survival of ovarian cancer patients, a multidisciplinary clinical approach is needed for these patients. In addition, the study suggests that clinicians either identify or develop medications that can benefit the prognosis of ovarian cancer and stabilize blood glucose at the same time.
“Ovarian cancer patients with diabetes mellitus will face the adverse health effects from both diseases,” said Zhang. “Our study suggests that there is a great need for oncologists to consider the role of DM and anti-diabetic intervention in tertiary prevention and clinical treatment of ovarian cancer.”
In addition to Zhang, co-authors from the Gillings School epidemiology department are Tengteng Wang, MSPH, MBBS, Yuzhi Xi, BS, and Nan Li, MS, MBBS. Hongtai Huang, PhD, postdoctoral researcher in obstetrics and gynecology at the University of California at San Francisco, and Yuan Zhao, MHS, epidemiology researcher at Johns Hopkins University School of Medicine, are also co-authors.