Diabetes mellitus and breast cancer: a retrospective population-based cohort study

被引:83
作者
Lipscombe, Lorraine L.
Goodwin, Pamela J.
Zinman, Bernard
McLaughlin, John R.
Hux, Janet E.
机构
[1] Inst Clin Evaluat Sci, Toronto, ON M4N 3M5, Canada
[2] Univ Toronto, Dept Med, Toronto, ON, Canada
[3] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada
[4] Sunnybrook & Womens Coll Hlth Sci Ctr, Toronto, ON, Canada
[5] Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada
[6] Mt Sinai Hosp, Samuel Lunenfeld Res Inst, Toronto, ON M5G 1X5, Canada
基金
加拿大健康研究院;
关键词
breast cancer; cohort study; diabetes; epidemiology; insulin resistance; risk;
D O I
10.1007/s10549-006-9172-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose. Evidence suggests that women with type 2 diabetes may be at increased risk of breast cancer, possibly due to chronic exposure to insulin resistance and/or hyperinsulinemia. The purpose of this study was to compare the incidence of breast cancer in postmenopausal women with and without diabetes. Methods. Using population-based validated health databases from Ontario, Canada, this retrospective cohort study compared breast cancer incidence between women, aged 55 - 79 years, with newly diagnosed diabetes (n = 73,796) to women without diabetes (n = 391,714). Results. Women with diabetes were slightly older, were more likely to reside in a lower income neighborhood, had greater comorbidity, and had more annual physician visits than women without diabetes. After 2.2 million person-years of follow-up from 1994 to 2002, breast cancer incidence was 2.97/1000 person-years in the diabetes group and 2.75/1000 person-years in the non-diabetes group. After adjustment for age and income, there was a significant increase in breast cancer among women with diabetes (hazard ratio, HR, 1.08, 95% confidence interval, CI, 1.01 - 1.16, p = 0.021). Conclusion. This study found a small but significant increase in incident breast cancer in a predominantly postmenopausal population of women with diabetes, when compared to women without diabetes. These results support the possibility that insulin resistance or some other aspect of type 2 diabetes may promote breast cancer, and may further direct treatment and prevention strategies.
引用
收藏
页码:349 / 356
页数:8
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