This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Oncology  • Breast Cancer  • Colon Cancer  • Ovarian Cancer  • Oncology, Other  • Statistics and Research Methods  • Endocrine Diseases  • Diabetes Mellitus  • Gastroenterology  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: The meta-analysis by Dr Barone and colleagues¹ showed that patients diagnosed with cancer who have preexisting diabetes are at increased risk for all-cause mortality compared with those without diabetes. We agree with this conclusion but have 2 comments. First, the study by Kouvaris et al² included only 30 cancer patients with diabetes and 50 patients in total. Therefore, we wonder whether in Figure 2 the random-effects weight and the large data marker are correct.

Second, the authors discussed the possibility that patients with preexisting diabetes may present with later-stage disease. In our study of 5555 newly diagnosed cancer patients with diabetes, we found that they presented more often with later-stage colon, breast, or ovarian cancer than patients without diabetes.³ Adjustment for stage and treatment decreased the hazard ratio (HR) for overall mortality for women with ovarian cancer from 1.50 (95% confidence interval [CI], 1.16-1.93) to 1.31 (95% . . . [Full Text of this Article]

Lonneke van de Poll-Franse, PhD
l.vd.poll@ikz.nl

Jan Willem Coebergh, MD, PhD
Comprehensive Cancer Centre South
Eindhoven, the Netherlands

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Long-term All-Cause Mortality in Cancer Patients With Preexisting Diabetes Mellitus: A Systematic Review and Meta-analysis
Bethany B. Barone, Hsin-Chieh Yeh, Claire F. Snyder, Kimberly S. Peairs, Kelly B. Stein, Rachel L. Derr, Antonio C. Wolff, and Frederick L. Brancati
JAMA. 2008;300(23):2754-2764.
ABSTRACT | FULL TEXT  

RELATED LETTER

Long-term Mortality in Cancer Patients With Preexisting Diabetes—Reply
Bethany B. Barone, Hsin-Chieh Yeh, and Frederick L. Brancati
JAMA. 2009;301(15):1541.
EXTRACT | FULL TEXT