INS and cancer: For the causes of mortality, risks of death from cancer (fully adjusted RR = 2.16, 95% CI 1.39–3.35, P = 0.001, Table 2, Figure 2C) and from pneumonia and respiratory system diseases (fully adjusted RR = 2.31, 95% CI 1.27–4.18, P = 0.006) were significantly higher in the insulin users compared with the non-insulin users.