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 An analysis of data from studies over two decades finds that women
with diabetes are less likely than those without the disease to get
screened for cervical, breast and colorectal cancers.
"We know people with diabetes have a small, but significantly
increased risk for certain kinds of cancer. We wanted to find out if
lower cancer screening is contributing to these differences," said
senior researcher Dr. Lorraine Lipscombe, an endocrinologist at
Women's College Hospital and an associate professor of medicine at
the University of Toronto.
"And, if there is a higher risk of cancer, we wanted to make sure
we're at least catching the cancers early," Lipscombe told Reuters
Health in a phone interview.
The authors searched for studies done between 1997 and 2018 on rates
of recommended screening tests in adults with diabetes: mammography
for breast cancer and Papanicolaou (Pap) test for cervical cancer in
women, and fecal blood or colonoscopy tests for colorectal cancer in
women and men.
Of the 37 studies included in the analysis, 21 were from the U.S.,
three were from Canada and the rest from Europe, the Middle East and
Asia. Study groups ranged in size from 129 to 732,687 people.
Overall in the studies, women with diabetes were 24% less likely
than women without diabetes to get cervical cancer screening and 17%
less likely to get breast cancer screening, researchers reported in
Diabetologia.
When the study team looked at rates of colorectal screening, women
with diabetes were 14% less likely than women without the disease to
be screened, while men with and without diabetes had similar
screening rates.
Diabetes has a high burden of care, Lipscombe said.
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"The complexity and time taken to manage diabetes could mean routine
preventive services such as cancer screening may be forgotten or
neglected, by both patients and providers."
It's not clear why colon cancer screening rates diverged only for
women, she noted. "We wonder if there is a perception that
colorectal cancer is more common in men than women."
"Patients with diabetes get screened for development of traditional
diabetes complications like retinopathy, nephropathy and neuropathy,
and blood pressure, lipid monitoring and treatment," noted Dr. Emily
J. Gallagher, an assistant professor of endocrinology, diabetes and
bone disease at the Icahn School of Medicine at Mount Sinai in New
York City, who wasn't involved in the study.
The focus on managing diabetes may result in cancer getting lower
priority, said Gallagher, whose practice focuses on diabetes and
endocrine conditions in cancer patients.
She agrees with the researchers that better awareness of the
importance of cancer screenings among diabetes patients and their
healthcare providers is needed.
"We know the more chronic diseases a person has, the less likely
they are to see their primary care provider, but the latter must
stay part of the team," Lipscombe said.
The good news, she added, is with early cancer screening, "the
prognosis is as good for diabetics as it is for people without the
illness."
SOURCE: https://bit.ly/324wkG7 Diabetologia, online October 24,
2019.
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