Prevalence of Cancers of Female Organs among Patients with Diabetes Type 2 in Kelantan, Malaysia: Observations over an 11 Year Period and Strategies to Reduce the Incidence

Introduction: Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2).Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known.
Objective: To determine the proportion of breast, cervical, ovarian and endometrial cancers among femaleswith DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period. Materials and
Methods: All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admittedto the Hospital were included in the study. The patient diabetic status was traced from the hospital medicalrecords.
Results: There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas overthis period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860(18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%)were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1%(51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer23.3% (37/159).
Conclusions: There is a significant proportion of DM2 among women with these four cancers,endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend ofthese four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetesis prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening forthese cancers among their female patients and gynecology clinics should screen the women they treat for theirdiabetes status.