ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Renal Endocrinology
This article is part of the Research TopicCancer, Metabolism and Kidney Injury: From Molecular Mechanisms to TherapyView all 8 articles
Combined effect of Diabetes and Obesity on Cancer Risk in Chronic Kidney Disease: A nationwide population-based study
Provisionally accepted
Chang Seong Kim1
Sang Heon Suh1
Hong Sang Choi1
Eun Hui Bae1
Seong Kwon Ma1
JinHyung Jung2
Bongseong Kim3
Kyungdo Han3*
Soo Wan Kim1*- 1Chonnam National University Medical School, Gwangju, Republic of Korea
- 2The Catholic University of Korea, Jongno-gu, Republic of Korea
- 3Soongsil University, Dongjak-gu, Republic of Korea
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Background: The effects of diabetes and obesity on cancer risk in patients with chronic kidney disease (CKD) remain unclear. We examined the independent and combined effects of diabetes, body mass index (BMI), and waist circumference (WC) on overall and site-specific cancer risk in CKD. Methods: Overall, data from 1,955,504 adults aged ≥ 20 years who underwent health checkups (2012–2017) were analyzed using the Korean National Health Insurance Service database. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m² or proteinuria. Participants were stratified using glycemic status (normal, impaired fasting glucose [IFG], and diabetes), BMI (<18.5, 18.5–23, 23–25, 25–30, ≥30 kg/m²), and sex-specific WC categories. Results: During a median 7.7-year follow-up, 162,463 new cancer cases (8.3%) were identified among 1,955,504 participants with CKD. Compared with individuals with normal fasting glucose (NFG), those with IFG and diabetes had significantly higher overall cancer risk (adjusted HR [aHR] 1.025, 95% CI 1.012–1.037 and aHR 1.176, 95% CI 1.162–1.190, respectively). Higher BMI and WC were associated with cancer risk, with the highest categories showing aHRs of 1.080 (95% CI 1.056–1.105) and 1.128 (95% CI 1.106–1.152), respectively. Site-specific analyses showed diabetes was strongly associated with liver, gallbladder, and pancreatic cancers. Higher BMI and WC increased hepatobiliary, kidney, and female-specific cancer risks. Combined diabetes and obesity amplified risks, especially for gastrointestinal and female-specific cancers, while prostate cancer risk declined with lower BMI or WC regardless of diabetes. Conclusions: In this large CKD cohort, diabetes and obesity independently and jointly increased overall and site-specific cancer risk, particularly gastrointestinal and female-specific cancers.
Keywords: Body Mass Index, cancer risk, Chronic Kidney Disease, Diabetes Mellitus, Obesity, Waist Circumference
Received: 18 Sep 2025; Accepted: 06 Feb 2026.
Copyright: © 2026 Kim, Suh, Choi, Bae, Ma, Jung, Kim, Han and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Kyungdo Han
Soo Wan Kim
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