Glycaemic index and glycaemic load in relation to risk of diabetes-related cancers: a meta-analysis

Diets high in glycaemic index (GI) or glycaemic load (GL) have been hypothesised to increase the risks of certain cancers by increasing blood glucose or insulin concentrations. We aimed to conduct a meta-analysis of prospective cohort studies to evaluate the association between GI or GL and diabetes-related cancers (DRC), including bladder, breast, colon-rectum, endometrium, liver and pancreas, which are associated with an increased risk for diabetes, and prostate cancer, which is associated with a reduced risk for diabetes. We searched Pubmed, EMBASE and MEDLINE databases up to September 2011 and reference lists of relevant articles. Relative risks (RR) and 95% CI for the highest v. the lowest categories were extracted and pooled using a random-effects model. Thirty-six prospective cohort studies with a total of 60 811 DRC cases were included in the present meta-analysis. In a comparison of the highest and lowest categories, the pooled RR of DRC were 1.07 (95% CI 1.04, 1.11; n = 30) for GI and 1.02 (95% CI 0.96, 1.08; n = 33) for GL. In an analysis of site-specific cancer risks, we found significant associations for GI in relation to breast cancer (RR 1.06; 95% CI 1.02, 1.11; n = 11) and colorectal cancer (RR 1.08; 95% CI 1.00, 1.17; n = 9 studies). GL was significantly associated with the risk of endometrial cancer (RR 1.21; 95% CI 1.07, 1.37; n = 5). In conclusion, the findings of the present study suggest a modest-to-weak association between a diet that induces a high glucose response and DRC risks.