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Cancer Causes & Control
Published in: Cancer Causes & Control 11/2012

01-11-2012 | Original paper

Associations of type 2 diabetes and diabetes treatment with breast cancer risk and mortality: a population-based cohort study among British women

Authors: Maria Theresa M. Redaniel, Mona Jeffreys, Margaret T. May, Yoav Ben-Shlomo, Richard M. Martin

Published in: Cancer Causes & Control | Issue 11/2012

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Abstract

Purpose

There is great interest in whether type 2 diabetes and its treatments alter breast cancer risk and prognosis, but previous studies are inconclusive. We conducted a cohort study within the UK General Practice Research Database to investigate associations of type 2 diabetes and patterns of diabetes treatment with breast cancer risk and all-cause mortality.

Methods

We identified 52,657 women with type 2 diabetes, diagnosed between 1987 and 2007, and 30,210 randomly selected women without diabetes. We performed a time-dependent analysis using Cox proportional hazards models.

Results

Diabetes was associated with a 29 % increased overall breast cancer risk (95 % CI: 1.16–1.44), but the association markedly attenuated when adjusted for age, period of cohort entry, region, and body mass index (BMI) (HR: 1.12; 95 % CI: 0.98–1.29). Women with breast cancer and pre-existing diabetes had a 49 % (95 % CI: 1.17–1.88) increased all-cause mortality risk compared with women with breast cancer but without diabetes, after controlling for age, period, region, BMI, smoking, alcohol, and deprivation. Compared with sulfonylurea, we found weak evidence that metformin monotherapy (HR: 1.04; 95 % CI: 0.79–1.37) and insulin (HR: 1.33; 95 % CI: 0.63–2.83) modified breast cancer risk among women with diabetes.

Conclusions

We found weak evidence that diabetes is associated with a small increased risk of breast cancer. Among treated women, there is no evidence that anti-diabetes treatments modify the risk of developing breast cancer, with wide confidence intervals indicating imprecise effect estimates. Women with breast cancer and diabetes, however, had an increased all-cause mortality risk highlighting the potential importance of maintaining adequate glycemic control alongside anti-cancer treatments and subsequent follow-up.
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Metadata
Title
Associations of type 2 diabetes and diabetes treatment with breast cancer risk and mortality: a population-based cohort study among British women
Authors
Maria Theresa M. Redaniel
Mona Jeffreys
Margaret T. May
Yoav Ben-Shlomo
Richard M. Martin
Publication date
01-11-2012
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 11/2012
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-012-0057-0

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