Incidence of diabetes among postmenopausal breast cancer survivors

Abstract

Aims/hypothesis Evidence is emerging of an association between breast cancer and diabetes; however, it is uncertain whether diabetes incidence is increased in postmenopausal breast cancer survivors compared with women without breast cancer. The objective of this study was to determine whether postmenopausal women who develop breast cancer have a higher incidence of diabetes than those who do not develop breast cancer. Methods We used population-based data from Ontario, Canada to compare the incidence of diabetes among women with breast cancer, aged 55 years or older, from 1996 to 2008, with that of age-matched women without breast cancer. We used Cox proportional hazard models to estimate the effect of breast cancer on the cause-specific hazard of developing diabetes overall and in the subgroup of women who received adjuvant chemotherapy. Results Of 24,976 breast cancer survivors and 124,880 controls, 9.7% developed diabetes over a mean follow-up of 5.8 years. The risk of diabetes among breast cancer survivors compared with women without breast cancer began to increase 2 years after diagnosis (HR 1.07 [95% CI, 1.02, 1.12]), and rose to an HR of 1.21 (95% CI, 1.09, 1.35) after 10 years. Among those who received adjuvant chemotherapy (n04,404), risk was highest in the first 2 years after diagnosis (HR 1.24 [95% CI 1.12, 1.38]) and then declined. Conclusions/interpretation We found a modest increase in the incidence of diabetes among postmenopausal breast cancer survivors that varied over time. In most women the risk began to increase 2 years after cancer diagnosis but the highest risk was in the first 2 years in those who received adjuvant therapy. Our study suggests that greater diabetes screening and prevention strategies among breast cancer survivors may be warranted.

Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality

“…After the initial period, the risk of some cancers remained elevated, including colorectal, liver and endometrial cancer, and pancreatic cancer, while after the initial 3 mo period, men with type 2 diabetes had a lower risk of prostate cancer diagnosis in this retrospective cohort (93). A similar observation was reported in a retrospective study of breast cancer incidence from Australia (150), and in a study from Canada that reported that 9.7% of 24,976 patients diagnosed with breast cancer were diagnosed with diabetes within 5.5 yr of follow up (118). The authors of these studies suggest that the increased incidence of breast cancer around the time of diabetes diagnosis is because of the risk of cancer being greatest in the prediabetes phase (118,150).…”

Evaluation of Serum Lipids and C-peptide among Breast Cancer Patients with Chemotherapy

“…Our finding was in accordance to the study conducted by Yadav et alon breast cancer patients [5]. A study by Irwin et alreported an increased C-peptide levelin breast cancer survivoris associated with higher risk of breast cancer related death [11,24].A population based study found increased risk of diabetes among postmenopausal breast cancer survivors and patients who received adjuvant chemotherapy [17]. A study by Chaudhary et al reported increased incidence of obesity or weight gain during breast cancer management [27].In this study we observed altered metabolism of lipids and Cpeptide as the consequences of BC chemotherapy.…”

“…However, many epidemiological studies explored the contradictory causal association between dyslipidemia and breast cancer incidence [15,16]. Furthermore, previous studies revealed incidence of diabetes, lipid dysregulation and altered nutrients metabolism during the breast cancer management with chemotherapy [9,10,17].…”

“…More than one quarter of the BC diagnosed in Nepal is inyoung female with familial history of breast cancer, early pregnancy, longer lactation and estrogen exposureand tumors oftenshowing aggressive biological behaviors [4][5][6].Among chemotherapeutic agents, anthracyclines based treatment regime were reported to cause cardiotoxicity by increasing intramyocardial free radical production, lipid alterationsanddecreasing antioxidant level by adversely affecting dietary intake and nutritional status of the patients [7][8][9].Cancer cells reprogram their enzyme and signaling pathways to meet higher need of building blocks required for abnormal proliferation and their survival [13][14][15][16][17]. An association between altered lipids metabolism, diabetes, cardiovascular riskand other metabolic dysregulation with chemotherapy has been identified but underlying mechanismis not clear.…”

eHealth and behavioral weight loss interventions for female cancer survivors: A review

“…2 Overweight and obesity have been related to an increased risk of cancer recurrence and decreased survival. [3][4] In addition, compared with individuals without a history of cancer, cancer survivors have an increased risk for future cancer, 5 diabetes mellitus type II and cardiovascular disease [6][7] and may experience poorer health-related quality of life. [8][9] Weight loss has been associated with a better healthrelated quality of life and overall well-being and a decreased risk of cardiovascular disease, type II diabetes and mortality in cancer survivors.…”