If you don't have any of the well-known risk factors for cancer, including smoking, a family history of cancer of long-term exposure to a carcinogen such as asbestos, you may think that your risk for the disease is average or even less than average.

What you may not realize: Although most of the cancer predispositions (genetic, lifestyle and environmental factors that increase risk for the disease) are commonly known, there are several medical conditions that also can increase your risk, such as diabetes.

Unfortunately, many primary-care physicians do not link diabetes to cancer. As a result, they fail to prescribe the tests and treatments that could keep cancer at bay or reduce the condition's cancer-causing potential.

The high blood sugar levels that occur with type 2 diabetes predispose you to heart attack, stroke, nerve pain, blindness, kidney failure, a need for amputation-and cancer.

New research: For every 1 % increase in HbAlc-a measurement of blood sugar levels over the previous three months-there is an 18% increase in the risk for cancer, according to a study published in Current Diabetes Reports.

Other current studies have linked type 2 diabetes to a 94% increased risk for pancreatic cancer... a 38% increased risk for colon cancer... a 15% to 20% higher risk for postmenopausal breast cancer... and a 20% higher risk for blood cancers such as non-Hodgkin's lymphoma and leukemia.

What to do: If you have type 2 diabetes, make sure your primary-care physician orders regular screening tests for cancer, such as colonoscopy and mammogram.

Screening for pancreatic cancer is not widely available, but some of the larger cancer centers (such as the H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida, and the Mayo Clinic in Rochester, Minnesota) offer it to high-risk individuals.

This typically includes people with long standing diabetes (more than 20 years) and/ or a family history of pancreatic cancer. The test involves an ultrasound of both the stomach and small intestine, where telltale signs of pancreatic cancer can be detected.

Also work with your doctor to minimize the cancer-promoting effects of diabetes. For example, control blood sugar levels through a diet that emphasizes slow-digesting foods that don't create spikes in blood sugar levels, such as vegetables and beans. Also, try to get regular exercise-for example, 30 minutes of walking five or six days a week. Studies have shown that regular exercise helps to control blood sugar. And consider medical interventions, such as use of the diabetes drug metformin (Glucophage).

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