Mumbai: People living with diabetes may face a higher risk of developing several types of cancer, with a 2026 review highlighting an association between the two conditions across 21 of the 24 most common cancers. The findings, based on a nationwide analysis involving nearly five million people, have renewed attention on the role of metabolic health in cancer prevention and treatment.
Published in Diabetes Therapy, the review titled The Bidirectional Relationship Between Diabetes and Cancer: Mechanistic Insights, Epigenetic Intermediaries, and Therapeutic Approaches examines how the two diseases may influence each other.
The strongest associations were reported for liver and pancreatic cancers, with higher incidence also observed in colorectal, breast, endometrial, kidney, bladder and stomach cancers. The increase in relative cancer incidence ranged from 11% for non-Hodgkin lymphoma to over 200% for liver cancer. However, researchers clarified that an association does not establish direct causation.
Insulin resistance, elevated insulin levels, persistent high blood sugar and chronic inflammation are among the possible biological links. These conditions can influence cellular growth, DNA damage and pathways involved in tumour development.
The review also highlights evidence from South India suggesting a connection between type 2 diabetes and oral cancer. This is particularly relevant for India, where approximately 101 million adults live with diabetes and another 136 million have prediabetes.
The relationship also works in reverse. Pancreatic cancer, steroids, immunotherapy and certain targeted cancer treatments can disrupt glucose regulation. Cancer survivors have also been found to face a 39% higher risk of developing diabetes.
Researchers stress the importance of integrating metabolic monitoring with cancer care. Regular physical activity, healthy weight management, balanced nutrition and appropriate cancer screening remain important. They also caution that diabetes medication, including metformin, should not be considered an established cancer-prevention treatment.
