We assessed gastric cancer risk in type 2 diabetes mellitus patients. Gastric cancer patients with diabetes between 2001–2012 were identified. Four groups were analysed: combination therapy with metformin users; insulin and other medication users; metformin and insulin users; and sulfonylurea users. Standardised incidence ratios (SIRs) for gastric cancers as a ratio of the observed number of cancer cases in people with diabetes to the expected number of cancer cases in the underlying general population were calculated. A total of 99,992 patients with diabetes were analysed and 337 gastric cancer cases in patients with diabetes were observed when compared to the expected number of 400.54 gastric cancer cases, according to the cancer rates of the general population (SIR 0.84, 95% confidence interval (CI): 0.76–0.94). Lower risk of gastric cancer was found both in male and female patients with diabetes, however, risk among females was insignificantly lower. Higher gastric cancer risk was found in the group of diabetic patients treated with sulfonylureas (SIR 1.31, 95% CI: 1.04–1.65) and significantly lower risk than expected from the general population was found in the group of metformin users (SIR 0.75, 95% CI: 0.66–0.86). Type 2 diabetes mellitus was not associated with increased risk of gastric cancer. Metformin might decrease the risk of gastric cancer in patients with diabetes, while sulfonylureas may increase gastric cancer risk.

The aim of this study was to examine the association between type 2 diabetes (T2DM), use of glucose-lowering medications and endometrial cancer (EC) risk. Methods: The risk of EC incidence among women with T2DM in Lithuania was assessed using a retrospective cohort study design. Female patients who were registered with T2DM between 1 January 2000 and 31 December 2012 were identified in the National Health Insurance Fund database. EC cases (ICD-10 code C54) were identified from the Lithuanian Cancer Registry. Standardized incidence ratios (SIRs) were calculated by dividing the observed numbers of EC among patients with T2DM by the expected number of EC, calculated using national rates. Results: A total of 77,708 diabetic women were included in the analysis, and 995 cases of EC were identified. A significantly increased EC risk in diabetic women was found as compared to the general population (SIR = 1.69, 95% CI 1.59–1.80). The greatest EC risk was found among younger patients at T2DM diagnosis, and the risk declined gradually with increasing age but persisted in being significantly increased among all age groups. The risk for EC increased with increasing duration of diabetes, and the highest EC risk was observed more than 10 years after T2DM diagnosis. A significantly higher EC risk than expected from the general population was found in all patient groups by glucose-lowering medication combinations. The lowest EC risk was observed in diabetic women who were users of “oral only” (without metformin) (SIR = 1.42, 95% CI 1.10–1.83) and “metformin only” (SIR = 1.69, 95% CI 1.49–1.92) medications. A two times greater EC risk was observed among the remaining glucose-lowering medication categories. In contrast, use of insulin only was not related to a higher EC incidence risk (SIR = 0.45, 95% CI 0.23–0.86); however, the risk estimation was based on nine cases. Conclusions: Our study shows a significantly increased EC risk in diabetic women as compared to the general population. In this study, a significantly higher EC risk was found in all patient groups by glucose-lowering medication combinations, except for insulin only users.

Purpose: The aim of our study was to assess overall survival and cancer-specific survival in endometrial cancer patients with type 2 diabetes mellitus (T2DM) using metformin. Methods: Patients with endometrial cancer and T2DM during 2000–2012 period were identified from the Lithuanian Cancer Registry and the National Health Insurance Fund database. Cancer-specific and overall survival were primary outcomes. Results: In our study we included 6287 women with endometrial cancer out of whom 664 were diagnosed with T2DM (598 metformin users and 66 never users). During follow-up (mean follow-up time was 8.97 years), no differences in risk of endometrial cancer specific mortality was observed in diabetic patients treated with metformin (Hazard Ratio (HR) 0.87, 95% Confidence Interval (CI) 0.70–1.07). Overall mortality in the diabetic metformin ever users’ group was significantly higher compared with the non-diabetic endometrial cancer women (HR 1.17, 95% CI 1.03–1.32) and in the group of metformin never users with T2DM (HR 1.42, 95% CI 1.07–1.87). Conclusion: Our study results suggest no beneficial impact on overall and cancer-specific survival in endometrial cancer patients who were treated with metformin as part of their diabetes treatment.

Background and Objectives: Rheumatoid arthritis (RA) is a multisystem autoimmune disease that needs immunosuppressive treatment. Previously, studies have shown an increased risk of cancer in patients with RA compared with the general population. The purpose of this study was to explore the associations between RA and cancer risk, providing updated insights into the incidence of specific cancers in patients with RA. Materials and Methods: A total of 746 cancer cases were observed, with the most common types being nonmelanoma skin cancer (139 cases), breast cancer (87 cases), lung cancer (47 cases), and Hodgkin lymphoma (43 cases). Results: Compared with the general Lithuanian population, patients with RA had an increased overall cancer risk, with an SIR of 1.17 and 95% CI of 1.09–1.26. Hematological cancers and nonmelanoma skin cancers were the most common types of cancer in the RA population, and patients with RA had a significantly greater risk of site-specific cancers (non-Hodgkin lymphoma: SIR 4.19, 95% CI 1.57–11.18; Hodgkin lymphoma: SIR 3.03, 95% CI 2.11–4.36; myeloma: SIR 3.00, 95% CI 1.84–4.90; leukemia: SIR 2.39, 95% CI 1.62–3.54; and skin nonmelanoma: SIR 1.54, 95% CI 1.27–1.83). Male patients with RA had an increased risk of prostate and kidney cancer (SIR 1.40, 95% CI 1.12–1.75; SIR 1.85, 95% CI 1.11–3.06). Our study revealed a significantly lower risk of colorectal cancer among patients with RA. Additionally, we observed a statistically significant reduction in the risk of mouth and pharynx cancers; however, this finding was based on only three observed cases. Conclusions: Patients with RA remain particularly affected by an increased cancer risk. Knowing these risks, we need clear recommendations for specific screenings in patients with RA, which could allow for early diagnosis and better cancer treatment in the early stages.

Background and Objectives: Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality worldwide. Genetic and epigenetic changes, especially DNA methylation alterations, are key in CRC development. LINE-1 hypomethylation marks global DNA methylation loss and genomic instability, making it a potential early CRC biomarker. This study investigates the methylation status of LINE-1 in colorectal adenocarcinoma, precancerous lesions (tubular and serrated adenomas), and the surrounding normal mucosa, aiming to elucidate its role as an epigenetic marker in early colorectal tumorigenesis. Materials and Methods: Paired lesion and normal tissue samples from 66 patients were analyzed for LINE-1 methylation at three CpG sites using bisulfite pyrosequencing. Results: Adenocarcinomas and tubular adenomas showed significant hypomethylation, especially at loci A and B, while serrated adenomas exhibited no significant differences. Conclusions: LINE-1 hypomethylation is associated with colorectal tumorigenesis, with distinct patterns observed between tubular and serrated adenomas, indicating distinct pathways forming and progressing specific adenomas. These findings support the potential of LINE-1 methylation as an early epigenetic biomarker for CRC risk stratification and highlight the need for further research into its clinical utility.