Cancer Incidence Gap Widens in Patients With Type 2 Diabetes

Adults with type 2 diabetes (T2D) in Denmark developed cancer at higher rates than those without diabetes across a 27-year period, and that gap grew in recent years, according to a nationwide registry study presented at the European Association for the Study of Diabetes (EASD) 2026 Annual Meeting in Milan, Italy. The findings suggest cancer prevention and early detection may deserve a place in long-term diabetes care alongside cardiovascular and kidney protection.¹

In 2010 to 2022, overall cancer incidence was 12% higher among men with T2D and 22% higher among women with T2D compared with individuals without diabetes, up from 9% and 15%, respectively, in 1996 to 2009. Lead investigator Tinne Laurberg, PhD, a consultant and clinical associate professor in pathology at Steno Diabetes Center Aarhus, Aarhus University Hospital, said the findings "support greater recognition of cancer as a major long-term complication of T2D."¹

Cancer Emerging as a Leading Cause of Death

Earlier work from Laurberg and colleagues found that cardiovascular mortality fell among individuals with T2D in Denmark between 2002 and 2019 while cancer mortality remained high, making cancer the leading cause of death in this population. In that analysis, individuals with T2D had elevated mortality risk from nearly all cancer types, with the highest relative risks for liver, pancreatic, and kidney cancers.²

A separate multinational analysis of 11 high-income jurisdictions found that cancer was ultimately the leading cause of death among people with diabetes in 4 of them, and that cardiovascular disease is no longer universally the most common cause of death in this population.³

Study Design

For the new analysis, investigators used nationwide Danish health registries to follow adults aged 18 years and older from 1996 through 2022. Participants were classified as having no diabetes until a T2D diagnosis, after which they were categorized as having T2D. Follow-up continued until a cancer diagnosis, emigration, death, or December 31, 2022. Over 27 years, investigators identified 75,540 first cancers among individuals with T2D and 635,323 among those without diabetes.¹

Obesity-Related Cancers Drive the Gap

Obesity-related cancers showed the largest differences, with incidence 45% higher in men and 30% higher in women with T2D in 2010 to 2022, up from 34% and 23% in 1996 to 2009. Colorectal cancer incidence was 17% higher in men and 14% higher in women with T2D, and postmenopausal breast cancer incidence was 8% higher in women with T2D.¹

Patterns diverged for cancers not classified as obesity-related. Lung cancer incidence was 23% higher in men and 25% higher in women with T2D in the most recent period; among women, incidence shifted from 12% lower in 1996 to 2009 to 25% higher in 2010 to 2022. Prostate cancer incidence, by contrast, was 19% lower among men with T2D.¹

Laurberg told Pharmacy Times that the reason for the shift among women remains unclear. "Smoking prevalence among women in Denmark has declined substantially over recent decades. However, we do not know whether smoking patterns have changed differently among women with and without type 2 diabetes," she said. "Such differences could potentially contribute to the observed shift, but our study did not include individual-level smoking data to investigate this. We therefore cannot determine what explains this finding."

More broadly, the investigators cautioned that the study was designed to describe differences in incidence, not to determine whether T2D causes them. Factors such as body weight, smoking, alcohol use, and physical activity were beyond its scope, and classifying a cancer as obesity-related reflects a population-level association rather than an explanation for the differences observed.¹

Implications for Pharmacist Counseling

The American Diabetes Association (ADA) 2026 Standards of Care note that diabetes is associated with increased risk of cancers of the liver, pancreas, endometrium, colon and rectum, breast, and bladder. The guidelines advise that people with diabetes be encouraged to complete age- and sex-appropriate cancer screenings and to reduce modifiable risk factors, including obesity, physical inactivity, alcohol use, and smoking.⁴

Screening programs for common obesity-related cancers, such as colorectal and postmenopausal breast cancer, already exist in many countries, and Laurberg's team called for greater participation among people with T2D.¹

"Pharmacists can play an important role by reminding people with T2D to participate in existing cancer screening programs, particularly for common cancers such as colorectal and breast cancer," Laurberg said. "We know from previous research that recommendations from health care professionals can increase participation in cancer screening. Bringing up screening during relevant conversations with patients may therefore be a simple but valuable way to support participation."

Refill and medication review visits offer natural openings for those conversations, as well as for smoking cessation support.

Questions about medication safety may also come up. The ADA states that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have not been shown to be associated with the incidence of thyroid, pancreatic, or any other type of cancer in humans. The guidelines add that metformin and sulfonylureas may have anticancer properties but that recommendations cannot be made at this time.⁴

REFERENCES

1. Cancer incidence remains higher in people with type 2 diabetes, with the gap widening in recent years. News release. European Association for the Study of Diabetes. EurekAlert! September 22, 2026. Accessed October 12, 2026. https://www.eurekalert.org/news-releases/1144782

2. Laurberg T, Graversen SB, Sandbæk A, Wild SH, Vos RC, Støvring H. Trends in cause-specific mortality among people with type 2 and type 1 diabetes from 2002 to 2019: a Danish population-based study. Lancet Reg Health Eur. 2024;41:100909. doi:10.1016/j.lanepe.2024.100909

3. Magliano DJ, Morton JI, Chen L, et al. Trends in cause-specific mortality among people with and without diabetes in high-income settings: a multinational, population-based study. Lancet Diabetes Endocrinol. 2026;14(5):380-389. doi:10.1016/S2213-8587(25)00398-5

4. American Diabetes Association Professional Practice Committee for Diabetes. 4. Comprehensive medical evaluation and assessment of comorbidities: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S61-S88. doi:10.2337/dc26-S004