I have copied this from Medscape. The highlighting in bold is mine. Perhaps this research could help convince GPs that they should take diabetes and diabetes prevention seriously. It also makes more important the possible anti-cancer (as well as cardio-protective) effect of Metformin published online January 31 in the British Medical Journal. Chronic Diseases Raise Cancer Risk as Much as Lifestyle Does Kristin Jenkins February 01, 2018 Individual chronic diseases are "an overlooked risk factor for cancer" that collectively contribute to an increased cancer risk similar to that seen with all major lifestyle risk factors combined, say researchers. A prospective cohort study of more than 400,000 men and women shows that five common chronic diseases and their markers contributed to one fifth of new cancer cases (20.5%) and more than one third of all cancer deaths (38.9%). Over an average follow-up of 8.7 years, the impact on cancer incidence and mortality of diabetes; pulmonary disease; and markers for cardiovascular disease, chronic kidney disease, and gouty arthritis shortened lifespan by 13.3 years in men and 15.9 years in women, the authors report. These findings "revealed a previously overlooked yet substantial impact of chronic diseases on cancer risk" that is "just as important as five major lifestyle factors," say the researchers, led by Xifeng Wu, MD, PhD, from the University of Texas MD Anderson Cancer Center in Houston, Texas. "Current cancer prevention strategies focus on lifestyle risk factors and do not consider chronic diseases as modifiable cancer risk factors," Dr Wu told Medscape Medical News. On the basis of the results of the current study, "a major contributor of cancer incidence and mortality will be missed if future cancer prevention strategies do not target chronic diseases," she said. Recognizing that chronic diseases substantially increase cancer risk and shorten lifespan could stimulate better management of chronic diseases, improve overall health, and reduce cancer burden, Dr Wu suggested. An additional finding from the study was that physical activity was associated with a nearly 40% reduction in the excess risks for incident cancer and cancer death associated with chronic diseases and markers. "Clinicians may also want to recommend physical activity as an effective, inexpensive, and safe preventive strategy to reduce the risks of cancer and other chronic diseases," Dr Wu added. Study Details The observational study was carried out in Taiwan between 1996 and 2007. It examined data from 405,878 people without a history of cancer who underwent standardized medical screening.