Association of the severity of diabetes-related complications with stage of breast cancer at diagnosis among elderly women with pre-existing diabetes

Severity of Complications and Duration of Type 2 Diabetes and the Risk of Cancer: A Population-Based Study

BACKGROUND

The literature on the association between diabetes severity and cancer risk is limited and inconclusive. The study aimed to evaluate the association between the adapted Diabetes Complications Severity Index (aDCSI) and the duration of type 2 diabetes and cancer risk.

METHODS

Patients ages 20 years or older with newly diagnosed type 2 diabetes between January 1, 2007, and December 31, 2011, were identified from Taiwan National Health Insurance claims data. Standardized incidence ratios (SIR) were calculated to compare cancer incidence in people with diabetes with that in the general population. Poisson regression was used to examine whether SIRs differed by age, sex, aDSCI, and duration of diabetes.

RESULTS

A total of 756,547 patients were included, with a median follow-up of 8.8 years. Excluding the first year after diagnosis, the SIR for overall cancer was 1.18 [95% confidence interval (CI) 1.17-1.19]. Higher aDCSI was associated with increased SIRs for overall [SIR ratio 1.03 (1.02-1.03) per point increase], head and neck (1.03; 1.01-1.04), liver (1.04; 1.03-1.05), pancreas (1.03; 1.00-1.05), kidney (1.13; 1.10-1.15), and leukemia (1.09; 1.06-1.13). There was no association between aDCSI and colorectal, extrahepatic biliary tract, uterus and thyroid cancer, and a negative association with breast cancer (0.97; 0.95-0.98). Type 2 diabetes duration was associated with increased SIRs for overall [1.01 (1.00-1.02) per year increase], head and neck (1.03; 1.01-1.05), and liver cancer (1.04; 1.02-1.05).

CONCLUSIONS

The heterogeneity in the association between diabetes severity and diabetes-related cancers suggests diverse underlying connections.

IMPACT

Adopting distinct approaches in further research and prevention strategies for different kinds of diabetes-related cancers is important.

Exploring the Relationship Between Diabetes and Breast Cancer in the United Arab Emirates

Introduction This study delves into the complex interplay between diabetes and breast cancer within the United Arab Emirates (UAE), a subject of considerable global health concern. Given the increasing incidence of both diseases worldwide, this research investigates explicitly the potential influence of diabetes on the staging of breast cancer. The UAE, mirroring global trends, has experienced a surge in both conditions attributed to a blend of genetic, environmental, and lifestyle factors. The core objective of this investigation is to explore the link between diabetes and the stage at which breast cancer is diagnosed in UAE patients. Material and method To conduct this study, data were extracted from an extensive medical database consisting of anonymized records about breast cancer patients and their comorbid conditions. The research encompassed adult patients of all genders, all of whom had been definitively diagnosed with breast cancer. The data was analyzed using a suite of Python libraries, including Pandas, NumPy, SciPy, Scikit-learn, Matplotlib, and Seaborn. Descriptive and inferential statistical methods were employed, focusing on the Chi-Square test and logistic regression analysis to evaluate the relationship between diabetes and the stages of breast cancer, considering other comorbidities as well. Results The analysis included 131 breast cancer patients, predominantly female (98.47%), with an average age of 54.2 years. Among these patients, 22.14% were diabetic. The prevalence of other comorbidities, such as dyslipidemia, hypertension, and hypothyroidism, was also recorded. The Chi-Square test indicated no significant correlation between diabetes and the stages of breast cancer (χ² = 3.07, p = 0.381). Stage II was the most frequently diagnosed, irrespective of the presence or absence of diabetes. Conclusion In conclusion, this study finds no substantial link between diabetes and the stage of breast cancer diagnosis among patients in the UAE after adjusting for age and other comorbid conditions. These results underscore the need for early breast cancer detection approaches that are not exclusively dependent on the diabetic status of the patients. However, limitations such as the retrospective cohort design and the relatively small sample size highlight the necessity for further comprehensive studies. Such research would deepen the understanding of the relationship between diabetes and breast cancer and contribute to the advancement of breast cancer healthcare in the UAE.

Association between prior use of anti-diabetic medication and breast cancer stage at diagnosis

BACKGROUND

Knowledge regarding antidiabetic medication (ADM) use prior to breast cancer (BC) diagnosis remains limited. The objectives were to (1) evaluate if the prior use of ADM was associated with BC stage at diagnosis and (2) identify and compare patient characteristics among BC patients using different ADMs.

RESEARCH DESIGN AND METHODS

Newly diagnosed female BC patients exposed to any medication during one year prior to cancer diagnosis were identified in 2008-2013 Linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Stage at diagnosis, categorized as early and advanced, was the primary outcome. Chi-square tests were used to compare characteristics and logistic regression models were applied to examine the effect while controlling for patient's characteristics.

RESULTS

A total of 1,719 female BC patients used ADM while 6,084 patients were non-ADM users. Although a higher proportion of ADM users (20.36%) were diagnosed with advanced stage compared to the non-ADM users (14.46%), the difference was not statistically significant after adjusting for the patients' characteristics. Besides, insulin users were more likely to be diagnosed with advanced stage (adjusted odds ratio 1.69; 95% CI 1.15, 2.48) compared to metformin users.

CONCLUSIONS

The association between ADM use and BC diagnostic characteristics varied based on different treatments.

Diabetes and its Potential Impact on Head and Neck Oncogenesis

In recent years, the incidence of diabetes mellitus and cancer has increased sharply; indeed, these have become the two most important diseases threatening health and survival. Head and neck (HN) tumors are the sixth most common malignancies in humans. Numerous studies have shown that there are many common risk factors for diabetes mellitus and HN squamous cell carcinoma, including advanced age, poor diet and lifestyle, and environmental factors. However, the mechanism linking the two diseases has not been identified. A number of studies have shown that diabetes affects the development, metastasis, and prognosis of HN cancer, potentially through the associated hyperglycemia, hyperinsulinemia and insulin resistance, or chronic inflammation. More recent studies show that metformin, the first-line drug for the treatment of type 2 diabetes, can significantly reduce the risk of HN tumor development and reduce mortality in diabetic patients. Here, we review recent progress in the study of the relationship between diabetes mellitus and HN carcinogenesis, and its potential mechanisms, in order to provide a scientific basis for the early diagnosis and effective treatment of these diseases.

Diabetes and differences in detection of incident invasive breast cancer

Many women diagnosed with breast cancer have chronic conditions such as diabetes that may impact other health behaviors. Our purpose was to determine if breast cancer screening and detection differs among women with and without diabetes. We conducted a cross-sectional analysis of a retrospective cohort of women aged 52-74 years diagnosed with incident stages I-III breast cancer enrolled in an integrated health plan between 1999 and 2014 with linkage to the Surveillance, Epidemiology and End Results registry (n = 2040). Screening data were taken from electronic health records. We used multivariable modified Poisson regression models with robust standard errors to estimate relative risks (RR) and 95% confidence intervals (CI) for outcomes of (i) receipt of screening in the 2 years prior to diagnosis; (ii) symptom-detected breast cancer; and (iii) diagnosis of locally advanced stage III breast cancer. Compared to women without diabetes, women with diabetes were similar with respect to receipt of screening mammography (78% and 77%), symptom-detected breast cancer (46% and 49%), and stage III diagnosis (7% and 7%). In multivariable models adjusting for age and year of diagnosis, race, BMI, Charlson comorbidity score and depression diagnosis no differences were observed in the outcomes by presence of diabetes. Further investigation is warranted to determine how diabetes acts as a mediating factor in adverse breast cancer outcomes.