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Diabetes and breast cancer risk : a meta analysis

Boyle, Peter and Boniol, Mathieu and Koechlin, Alice Helene Marie and Robertson, Chris and Valentini, Faustine and Coppens, Kim and Fairley, Laura-Louise and Boniol, Magali and Zheng, Tongzhang and Zhang, Yawei and Pasterk, Markus and Smans, Michel and Curado, Maria Paula and Mullie, Patrick and Gandini, Sara and Bota, Maria and Bolli, Geremia and Rosenstock, Julio and Autier, Philippe (2012) Diabetes and breast cancer risk : a meta analysis. British Journal of Cancer, 107 (9). pp. 1608-1617. ISSN 0007-0920

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Abstract

The potential of an increased risk of breast cancer in women with diabetes has been the subject of a great deal of recent research. A meta-analysis was undertaken using a random effects model to investigate the association between diabetes and breast cancer risk. Thirty nine independent risk estimates were available from observational epidemiological studies. The Summary Relative Risk (SRR) for breast cancer in women with diabetes was 1.27 (95% Confidence Interval (CI), 1.16-1.39) with no evidence of publication bias. Prospective studies showed a lower risk (SRR 1.23 [95% CI, 1.12-1.35]) than retrospective studies (SRR 1.36 [95% CI, 1.13-1.63]). Type 1 diabetes, or diabetes in pre-menopausal women, were not associated with risk of breast cancer (SRR 1.00 [95% CI, 0.74-1.35] and SRR 0.86 [95% CI, 0.66-1.12] respectively). Studies adjusting for body mass index (BMI) showed lower estimates (SRR 1.16 [95% CI, 1.08-1.24]), as compared to those not adjusted (SRR 1.33 [95% CI, 1.18-1.51]). Conclusions: The risk of breast cancer in women with type 2 diabetes is increased by 27% but not for women at pre-menopausal ages or with type 1 diabetes. BMI appears to be a potential confounder related to both diabetes and breast cancer.