The association between diabetes and breast cancer stage at diagnosis: a population-based study
Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospectiv...
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| Veröffentlicht in: | Breast cancer research and treatment 2015-04, Vol.150 (3), p.613-620 |
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| container_title | Breast cancer research and treatment |
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| creator | Lipscombe, Lorraine L. Fischer, Hadas D. Austin, Peter C. Fu, Longdi Jaakkimainen, R. Liisa Ginsburg, Ophira Rochon, Paula A. Narod, Steven Paszat, Lawrence |
| description | Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study examined stage at diagnosis (II, III, or IV vs I) among women aged 20–105 years who were newly diagnosed with invasive breast cancer between 2007 and 2012. We compared those with diabetes to those without diabetes. Diabetes was defined based on medical records using a validated algorithm. Among 38,407 women with breast cancer, 6115 (15.9 %) women had diabetes. Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality. |
| doi_str_mv | 10.1007/s10549-015-3323-5 |
| format | Article |
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Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-015-3323-5</identifier><identifier>PMID: 25779100</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Breast cancer ; Breast Neoplasms - etiology ; Breast Neoplasms - pathology ; Cancer diagnosis ; Cancer research ; Cancer screening ; Cancer therapies ; Comorbidity ; Comparative analysis ; Cross-Sectional Studies ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Diabetics ; Epidemiology ; Female ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Neoplasm Staging ; Oncology ; Ontario - epidemiology ; Prognosis ; Retrospective Studies ; Risk Factors ; Womens health ; Young Adult</subject><ispartof>Breast cancer research and treatment, 2015-04, Vol.150 (3), p.613-620</ispartof><rights>Springer Science+Business Media New York 2015</rights><rights>COPYRIGHT 2015 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c606t-1b05ba4418ab5382336ca5176588ed760e811e355484d340cfbca48b8b8aa6b3</citedby><cites>FETCH-LOGICAL-c606t-1b05ba4418ab5382336ca5176588ed760e811e355484d340cfbca48b8b8aa6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-015-3323-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-015-3323-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25779100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lipscombe, Lorraine L.</creatorcontrib><creatorcontrib>Fischer, Hadas D.</creatorcontrib><creatorcontrib>Austin, Peter C.</creatorcontrib><creatorcontrib>Fu, Longdi</creatorcontrib><creatorcontrib>Jaakkimainen, R. Liisa</creatorcontrib><creatorcontrib>Ginsburg, Ophira</creatorcontrib><creatorcontrib>Rochon, Paula A.</creatorcontrib><creatorcontrib>Narod, Steven</creatorcontrib><creatorcontrib>Paszat, Lawrence</creatorcontrib><title>The association between diabetes and breast cancer stage at diagnosis: a population-based study</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study examined stage at diagnosis (II, III, or IV vs I) among women aged 20–105 years who were newly diagnosed with invasive breast cancer between 2007 and 2012. We compared those with diabetes to those without diabetes. Diabetes was defined based on medical records using a validated algorithm. Among 38,407 women with breast cancer, 6115 (15.9 %) women had diabetes. Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - etiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer diagnosis</subject><subject>Cancer research</subject><subject>Cancer screening</subject><subject>Cancer therapies</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetics</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Ontario - epidemiology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kU1v1DAQhi0EokvhB3BBkZAQlxQ7_kq4VRVfUiUue7fGzmQ3VdZePIlQ_z0OW6BFoDnY8jzvqxm_jL0U_EJwbt-R4Fp1NRe6lrKRtX7ENkJbWdtG2Mdsw4WxtWm5OWPPiG44553l3VN21mhru2KxYW67xwqIUhhhHlOsPM7fEWPVj1CuSBXEvvIZgeYqQAyYK5phV0TzyuxiopHeV1Ad03GZfnrUHgj7gi397XP2ZICJ8MXdec62Hz9srz7X118_fbm6vK6D4Wauhefag1KiBa9l20hpAmhhjW5b7K3h2AqBUmvVql4qHgYfQLW-FIDx8py9Pdkec_q2IM3uMFLAaYKIaSEnjOlaqYxuCvr6L_QmLTmW4QrVdQ1vjOR_qB1M6MY4pDlDWE3dpSp9JRutC3XxD6pUj4cxpIjDWN4fCN7cE-wRpnlPaVrWb6OHoDiBISeijIM75vEA-dYJ7tbw3Sl8V8J3a_hu1by622zxB-x_K36lXYDmBFBpxR3me6v_1_UH1hK2bw</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Lipscombe, Lorraine L.</creator><creator>Fischer, Hadas D.</creator><creator>Austin, Peter C.</creator><creator>Fu, Longdi</creator><creator>Jaakkimainen, R. Liisa</creator><creator>Ginsburg, Ophira</creator><creator>Rochon, Paula A.</creator><creator>Narod, Steven</creator><creator>Paszat, Lawrence</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20150401</creationdate><title>The association between diabetes and breast cancer stage at diagnosis: a population-based study</title><author>Lipscombe, Lorraine L. ; Fischer, Hadas D. ; Austin, Peter C. ; Fu, Longdi ; Jaakkimainen, R. 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Liisa</au><au>Ginsburg, Ophira</au><au>Rochon, Paula A.</au><au>Narod, Steven</au><au>Paszat, Lawrence</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between diabetes and breast cancer stage at diagnosis: a population-based study</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>150</volume><issue>3</issue><spage>613</spage><epage>620</epage><pages>613-620</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract>Women with diabetes have higher breast cancer incidence and mortality. The purpose of this study was to examine the impact of diabetes on stage at breast cancer diagnosis, as a possible reason for their higher mortality. Using population-based health databases from Ontario, Canada, this retrospective cohort study examined stage at diagnosis (II, III, or IV vs I) among women aged 20–105 years who were newly diagnosed with invasive breast cancer between 2007 and 2012. We compared those with diabetes to those without diabetes. Diabetes was defined based on medical records using a validated algorithm. Among 38,407 women with breast cancer, 6115 (15.9 %) women had diabetes. Breast cancer patients with diabetes were significantly more likely to present with advanced-stage breast cancer than those without diabetes. After adjustment for mammograms and other covariates, diabetes was associated with a significantly increased risk of Stage II [adjusted odds ratio (aOR) 1.14, 95 % confidence interval (CI) 1.07, 1.22], Stage III (aOR 1.21, 95 % CI 1.11, 1.33), and Stage IV (aOR 1.16, 95 % CI 1.01, 1.33) versus Stage I breast cancer. Women with diabetes had a higher risk of lymph node metastases (aOR 1.16, 95 % CI 1.06, 1.27) and tumors with size over 2 cm (aOR 1.16, 95 % CI 1.06, 1.28). Diabetes was associated with more advanced-stage breast cancer, even after accounting for differences in screening mammogram use and other factors. Our findings suggest that diabetes may predispose to more aggressive breast cancer, which may be a contributor to their higher cancer mortality.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>25779100</pmid><doi>10.1007/s10549-015-3323-5</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Breast cancer Breast Neoplasms - etiology Breast Neoplasms - pathology Cancer diagnosis Cancer research Cancer screening Cancer therapies Comorbidity Comparative analysis Cross-Sectional Studies Diabetes Diabetes mellitus Diabetes Mellitus - epidemiology Diabetics Epidemiology Female Humans Medicine Medicine & Public Health Middle Aged Mortality Neoplasm Staging Oncology Ontario - epidemiology Prognosis Retrospective Studies Risk Factors Womens health Young Adult |
| title | The association between diabetes and breast cancer stage at diagnosis: a population-based study |
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