People with type 2 diabetes who develop cancer are more likely to be diagnosed with advanced disease if the malignancy is not screened for routinely, according to a study presented at the European Breast Cancer Conference in Barcelona.

Researchers followed 11,945 cancer cases for a median of 15 years. Five per cent of cancers occurred in people with pre-existing cardiovascular disease (CVD), 7 per cent in people with type 2 diabetes and 1 per cent in people with both CVD and type 2 diabetes.

Type 2 diabetes patients had a 26 per cent increased risk of being diagnosed with metastasised cancer than those who did not have pre-existing cardiometabolic conditions. The increases in late diagnosis among people with CVD (7 per cent) and both CVD and type 2 diabetes (18 per cent) were not statistically significant, although the numbers enrolled were relatively small. 

Health services in the six European countries involved in the study screen populations for breast and colorectal cancer. “The good news is that for patients with breast or colorectal cancer, the national screening programmes seem to be detecting cancer often before it has started to spread, both for those with and without pre-existing diagnoses of cardiovascular disease and type 2 diabetes. Our findings underline the importance of participating in screening when invited,” says study author Dr Anna Jansana from  the International Agency for Research on Cancer in Lyon, France. 

“However, for cancers for which there are no national screening programmes, our results may prompt policymakers to broaden the scope of public health recommendations to encompass patients affected by cardiometabolic diseases and cancer. 

“At present, cancer screening guidelines do not include recommendations on cancer screening among people with cardiometabolic diseases. It may be necessary … to consider whether the recommendations need any adjustment in terms of cancer screening,” Dr Jansana adds. 

“In addition, healthcare professionals should pay special attention to people with pre-existing cardiometabolic conditions. Our findings suggest it might be worth developing interventions and treatments to target the common pathways involved in these non-communicable diseases.”