Background: Diabetes and chronic kidney disease (CKD)are both associated with an increased risk of cancer but it is unclear whetherdiabetes complicated by CKD further augments an individual's cancer risk. Theaim of our study was to determine the association of CKD [defined as anestimated glomerular filtration rate (eGFR) < 60 mL/min] with the overalland site-specific risks of incident cancers among individuals with Type 2diabetes.
Methods: Cox proportional hazard regression models and competing risk analyseswere used to examine the univariate and multivariate adjusted associationsbetween reduced kidney function and the overall and site-specific risks ofcancer in participants enrolled in the Action in Diabetes and Vascular disease:Preterax and Diamicron MR controlled evaluation (ADVANCE) trial.
Results: Over a median follow-up of 5.0 years, 700 malignant neoplasms occurredin the 11 140 (6.4%) participants. There was no increase in overall cancer risk[adjusted hazard ratio: 1.07 (95% confidence interval: 0.89-1.29, P = 0.50)] orsite-specific cancer risk for individuals with CKD (defined as eGFR < 60mL/min) compared to those without CKD at baseline. These results were robust tomultiple methods and thresholds used to estimate CKD.
Conclusions: Mild to moderate CKD does not increase therisk of cancer in people with Type 2 diabetes. ADVANCE is registered withClincalTrial.gov (number NCT00145925).