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Hyperinsulinemia & Cancer Risk: No Simple Relationship

P HILADELPHIA—An evergrowing body of evidence links obesity to an increased risk of developing many cancers. The mechanistic link between those two conditions, however, has yet to be elucidated. Two studies presented here at the American Association for Cancer Research’s Frontiers in Cancer Prevention Research conference illustrate the complexity of the relationship. One study shows that diabetic women are at increased risk of colon cancer, while the other shows that elevated insulin production protects men from prostate cancer. “There is virtually no common malignancy that has not escaped a link to obesity,” said Craig Thompson, MD, Director of the Abramson Cancer Center at the University of Pennsylvania. “The big question is: What is that link? Clearly there has to be more of an understanding of this basic problem.” To better understand the links between hyperinsulinemia, diabetes, and colon cancer, Andrew Flood PhD, Assistant Professor of Epidemiology and Community Health at the University of Minnesota, and colleagues analyzed data from a cohort of 45,519 women. The women initially participated in a breast cancer screening study in the 1970s, and then enrolled in this current trial between 1987 and 1989. All of the women were free of colon cancer diagnosis and type I diabetes when they completed baseline questionnaires about health and lifestyle factors. With a median follow-up of 8.5 years, the team identified 489 colorectal cancer cases in this cohort. When the researchers looked at the impact of diabetes (type II) at baseline on the likelihood of a subsequent colon cancer diagnosis, they found that diabetic women had a 50% greater risk than did women who did not have diabetes, after controlling for other risk factors such as age and physical activity. “That is interesting in and of itself, but it is not the first time someone observed that association,” Dr. Flood said, during a news conference in which he presented his data.