Endocr Relat Cancer. 2012 Oct 3. [Epub ahead of print]
Diabetes increases the risk of breast cancer: a meta-analysis.
Source
P Hardefeldt, The Whiteley-Martin Research Centre, The University of Sydney, Penrith, Australia.
Abstract
The hyperinsulinaemia associated with type 2 diabetes and the known proliferative effects of insulin has lead to the hypothesis that diabetes mellitus increases the risk of breast cancer. The aim of this meta-analysis was to collate and analyse all primary observational studies investigating the risk ofbreast cancer associated with diabetes. In addition, we aimed to complete sub group analyses by both type of diabetes and gender of study participants to further clarify the origin of any such association between the two. Studies were obtained from a database search of MEDLINE, EMBASE, PubMed, Current Contents Connect and Google Scholar with additional cross checking of reference lists. Collated data was assessed for heterogeneity and a pooled odds ratio calculated. 41 studies were included in the meta-analysis with 38 studies investigating breast cancer in women and 5 studies investigating breast cancer in men. Overall, we found a significantly increased risk of breast cancer associated with diabetes in both women (OR 1.24, 95% CI 1.15-1.35) and men (OR 1.40, 95% CI 1.10-1.79). After sub group analysis by type of diabetes the association was unchanged with Type 2 diabetes (OR 1.22, 95% CI 1.07-1.40) and nullified with gestational diabetes (OR 1.06, 95% CI 0.79-1.40). There were insufficient studies to calculate a pooled odds ratio of the risk of breast cancer associated with Type 1 diabetes. In conclusion, diabetes increases the risk of breast cancer in both women and men. This association is confirmed in women with type 2 diabetes and supports the hypothesis that diabetes is an independent risk factor for breast cancer.
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