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BACKGROUND Previous studies have demonstrated an association between diabetes mellitus and cancer risk. However to the author's knowledge, no data regarding the risk of cancer associated with subclinical impaired glucose tolerance have been published to date. An association between various types of cancer and any continuum of risk across the spectrum of glucose tolerance may be important in determining the nature of the association between diabetes mellitus and the risk of malignancy. METHODS The current study was conducted to examine the long‐term risk of malignant neoplasms associated with maternal glucose intolerance. A 20‐year follow‐up study of a cohort of women who had previously taken part in a study in 1980 that investigated maternal glucose metabolism and fetal outcome was performed. Gestational glucose metabolism, smoking behavior, and weight and height measured at the time of index pregnancy, as well as weight, height, and smoking behavior assessed by questionnaire in 1999, were examined. The main endpoint of the study was hospital admission with a diagnosis of malignant neoplasm as ascertained by linkage data. RESULTS Thirty‐four of the 753 women living in Grampian (4.5%) were admitted to the hospital with a diagnosis of malignant neoplasm; of these, 18 cases were malignant neoplasms of the breast. After adjustment for known risk factors, both malignant neoplasm and malignant neoplasm of the breast were found to be significantly associated with gestational glucose intolerance. CONCLUSIONS Subclinical glucose intolerance during pregnancy was found to be associated with a dose‐related increase in the risk of malignant neoplasm, particularly malignant neoplasm of the breast. Cancer 2004;100:149–55. © 2003 American Cancer Society.

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In parous women, higher BMI at index pregnancy, weight gain during follow-up and BMI in later life strongly predict diabetes risk.