Diabetes and cancer represent two complex, diverse, chronic, and potentially fatal diseases. Cancer is the second leading cause of death, while diabetes is the seventh leading cause of death with the latter still likely underreported. There is a growing body of evidence published in recent years that suggest substantial increase in cancer incidence in diabetic patients. The worldwide prevalence of diabetes was estimated to rise from 171 million in 2000 to 366 million in 2030. About 26.9% of all people over 65 have diabetes and 60% have cancer. Overall, 8–18% of cancer patients have diabetes. In the context of epidemiology, the burden of both diseases, small association between diabetes and cancer will be clinically relevant and should translate into significant consequences for future health care solutions. This paper summarizes most of the epidemiological association studies between diabetes and cancer including studies relating to the general all-site increase of malignancies in diabetes and elevated organ-specific cancer rate in diabetes as comorbidity. Additionally, we have discussed the possible pathophysiological mechanisms that likely may be involved in promoting carcinogenesis in diabetes and the potential of different antidiabetic therapies to influence cancer incidence. 1. Confounding Factors Patients with diabetes are at a higher risk than the general population of developing cancer of the urinary tract, liver, biliary tract, pancreas, colon, endometrium, and kidney. Several confounding factors directly associated with clinical diversities of diabetes are varying levels of metabolic controls, duration of diabetes, profiles of antidiabetic therapy, and the presence of complications or comorbidities. Therefore it is problematic to precisely evaluate cancer risk in diabetes. Moreover, shared risk factors for both diseases such as age, sex, ethnicity, alcohol, tobacco, diet, physical activity obesity, and BMI seem to further complicate the relation [1]. Although most of studies were adjusted for this and other confounders, particular contribution of obesity, diet, and physical activity to elevated cancer rate should be taken into account. These are factors that often coexist, influence, or even cause the diabetes and have also been shown to independently influence cancer risk. The majority of diabetic patients are obese or overweight [2]. The increased cancer risk in obesity has been established in several studies for cancers of the colon, rectum, breast, endometrium, pancreas, kidney, liver, gall bladder, and adenocarcinoma of esophagus [3].
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