Study Examines Link Between Breast Cancer and Diabetes
THURSDAY, Dec. 13 (HealthDay News) -- Postmenopausal breast
cancer survivors are at increased risk for developing diabetes and
should be screened for the disease more closely, a new study
suggests.
Researchers analyzed data from 1996 to 2008 from the province of
Ontario, Canada, to determine the incidence of diabetes among
nearly 25,000 breast cancer survivors aged 55 or older and nearly
125,000 age-matched women without breast cancer.
During a median follow-up of more than five years, nearly 10
percent of all the women in the study developed diabetes. Compared
to those who had not had breast cancer, the risk of diabetes among
breast cancer survivors was 7 percent higher two years after cancer
diagnosis and 21 percent higher 10 years after cancer diagnosis,
the investigators found.
The risk of diabetes, however, decreased over time among breast
cancer survivors who had undergone chemotherapy. Their risk
compared to women without breast cancer was 24 percent higher in
the first two years after cancer diagnosis and 8 percent higher 10
years after cancer diagnosis, according to the study, which was
published Dec. 12 in the journal
Diabetologia.
"It is possible that chemotherapy treatment may bring out
diabetes earlier in susceptible women," study author Dr. Lorraine
Lipscombe, of Women's College Hospital and Women's College Research
Institute in Toronto, said in a journal news release. "Increased
weight gain has been noted [after receiving] chemotherapy for
breast cancer, which may be a factor in the increased risk of
diabetes in women receiving treatment."
"Estrogen suppression as a result of chemotherapy may also
promote diabetes," Lipscombe added. "However, this may have been
less of a factor in this study where most women were already
postmenopausal."
The study authors suggested that there may be other factors
involved for women who received chemotherapy, including
glucocorticoid drugs, which are used to treat nausea in patients
receiving chemo and are known to cause spikes in blood sugar. In
addition, breast cancer patients undergoing chemotherapy are
monitored more closely and thus are more likely to have diabetes
detected, they noted.
The researchers said it is unclear why diabetes risk increased
over time among breast cancer survivors who did not receive
chemotherapy.
"There is, however, evidence of an association between diabetes
and cancer, which may be due to risk factors common to both
conditions," Lipscombe said. "One such risk factor is insulin
resistance, which predisposes to both diabetes and many types of
cancer -- initially insulin resistance is associated with high
insulin levels and there is evidence that high circulating insulin
may increase the risk of cancer."
"However, diabetes only occurs many years later when insulin
levels start to decline," she said. "Therefore, it is possible that
cancer risk occurs much earlier than diabetes in insulin-resistant
individuals, when insulin levels are high."
Overall, the "findings support a need for closer monitoring of
diabetes among breast cancer survivors," Lipscombe concluded.
Although the study found an association between diabetes and
breast cancer, it did not prove a cause-and-effect
relationship.
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