Examining associations of digestive system cancer with hypertension and diabetes using network analysis in older patients

Hypertension and diabetes are prevalent among older people and may be associated with cancer. Although several network analyses have been conducted to visualize the associations between diseases and relevant factors, to the best of our knowledge, none have focused on visualizing the associations between cancer and other diseases. We conducted a network analysis to explore the associations between cancer, hypertension, and diabetes. This study used a large-scale clinical dataset of 1,026,305 hospitalized patients aged ≥ 65 years, collected between April 2008 and December 2020. Diseases were categorized using the International Classification of Diseases-10 (2019 version) codes. The analysis focused on diseases with a prevalence of ≥ 1%. A multimorbidity network was constructed for the entire patient cohort, and the same analysis was applied specifically to cancer patients. Hypertension (degree centrality: 58/61) and diabetes (degree centrality: 56/61) were connected to several diseases, indicating significant multimorbidity in the cohort. The associations (observed-to-expected ratio) between digestive system cancers and hypertension and diabetes were relatively stronger than those between the diseases and other cancers. Type 2 diabetes and essential hypertension may be risk factors of cancers at multiple digestive system sites. Early treatment of these conditions could prevent or delay the progression of digestive system cancers.