癌症和糖尿病是全球死亡率和致残率最高的原因之一。几项研究表明，糖尿病是患癌症的危险因素之一，其关联可能可以通过与年龄、性别、体重、吸烟、饮酒等两种疾病共有的相关因素来解释。社会因素，即社会决定健康（SDOH），与癌症和糖尿病的风险相关。尽管糖尿病和社会因素被确定为癌症的重要决定因素，但没有研究考察它们对患癌症风险的联合影响。本研究旨在填补文献中的这一空白，通过三角关联糖尿病、SDOH指标与患癌症风险之间的关系。我们使用行为风险因素监测系统（BRFSS）的数据进行了定量研究，该系统在美国全国范围内收集了居民的健康相关风险行为、慢性疾病和预防服务使用信息。对389158名研究参与者进行了加权回归的数据分析。研究结果表明，糖尿病是一种增加患癌症可能性的危险因素，其糖尿病患者得癌症的几率增加了13%（OR 1.13; 95%CI：1.05-1.21）。白人患者患癌症的几率高于非裔美国人（OR 0.44; 95%CI：0.39-0.49）、亚洲人（OR 0.27; 95%CI：0.20-0.38）和其他种族（OR 0.56; 95%CI：0.46-0.69）。与患癌症有积极关联的SDOH指标包括失业（OR 1.78; 95%CI：1.59-1.99）、退休（OR 1.54; 95%CI：1.43-1.67）、较高收入水平（OR在1.16-1.38之间）、大学教育（OR 1.10; 95%CI：1.02-1.18）、大学毕业生（OR 1.31; 95%CI：1.21-1.40）和医疗保险覆盖（OR 1.44; 95%CI：1.22-1.71）。另一方面，对患癌症具有保护作用的SDOH指标包括租房居住（OR 0.86; 95%CI：0.79-0.93）和未婚（OR 0.73; 95%CI：0.65-0.81）。本研究为糖尿病和癌症之间的关联提供了一个新的社会维度，可以指导制定解决疾病预防和医疗保健准入中的社会不平等问题的策略。 版权所有 © 2023 Massouh, Jaffa, Tamim and Jaffa.

Cancer and diabetes are among the leading causes of morbidity and mortality worldwide. Several studies have reported diabetes as a risk factor for developing cancer, a relationship that may be explained by associated factors shared with both diseases such as age, sex, body weight, smoking, and alcohol consumption. Social factors referred to as social determinants of health (SDOH) were shown to be associated with the risk of developing cancer and diabetes. Despite that diabetes and social factors were identified as significant determinants of cancer, no studies examined their combined effect on the risk of developing cancer. In this study, we aim at filling this gap in the literature by triangulating the association between diabetes, indices of SDOH, and the risk of developing cancer.We have conducted a quantitative study using data from the Behavioral Risk Factor Surveillance System (BRFSS), whereby information was collected nationally from residents in the United States (US) with respect to their health-related risk behaviors, chronic health conditions, and the use of preventive services. Data analysis using weighted regressions was conducted on 389,158 study participants.Our findings indicated that diabetes is a risk factor that increases the likelihood of cancer by 13% (OR 1.13; 95%CI: 1.05-1.21). People of White race had higher odds for cancer compared to African Americans (OR 0.44; 95%CI: 0.39-0.49), Asians (OR 0.27; 95%CI: 0.20-0.38), and other races (OR 0.56; 95%CI: 0.46-0.69). The indices of SDOH that were positively associated with having cancer encompassed unemployment (OR 1.78; 95%CI: 1.59-1.99), retirement (OR 1.54; 95%CI: 1.43-1.67), higher income levels with ORs ranging between 1.16-1.38, college education (OR 1.10; 95%CI: 1.02-1.18), college graduates (OR 1.31; 95%CI: 1.21-1.40), and healthcare coverage (OR 1.44; 95%CI: 1.22-1.71). On the other hand, the indices of SDOH that were protective against having cancer were comprised of renting a home (OR 0.86; 95%CI: 0.79-0.93) and never married (OR 0.73; 95%CI: 0.65-0.81).This study offers a novel social dimension for the association between diabetes and cancer that could guide setting strategies for addressing social inequities in disease prevention and access to healthcare.Copyright © 2023 Massouh, Jaffa, Tamim and Jaffa.