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Association of diabetes and breast cancer characteristics at diagnosis

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Abstract

Purpose

This study aims to examine the association of diabetes and breast cancer characteristics at diagnosis in Aotearoa/New Zealand.

Methods

Patients diagnosed with invasive breast cancer between 2005 and 2020 were identified from the National Breast Cancer Register. Logistic regression modeling was used to estimate the adjusted odds ratio (OR) of having stage III–IV cancer and the OR of having stage IV cancer for women with diabetes compared to those without diabetes. The adjusted OR of having screen-detected breast cancers for patients aged 45–69 years with diabetes compared to patients without diabetes was estimated.

Results

26,968 women were diagnosed with breast cancer, with 3,137 (11.6%) patients having diabetes at the time of cancer diagnosis. The probability of co-occurrence of diabetes and breast cancer increased with time. Māori, Pacific and Asian women were more likely to have diabetes than European/Others. The probability of having diabetes also increased with age. For patients with diabetes, the probability of being diagnosed with stage III–IV cancer and stage IV cancer was higher than for patients without diabetes (OR 1.14, 95% CI 1.03–1.27; and 1.17, 95% CI 1.00–1.38). Women aged 45–69 years with diabetes were more likely to have screen-detected cancer than those without diabetes (OR 1.13, 95% CI 1.02–1.26).

Conclusions

The co-occurrence of diabetes and breast cancer is becoming more common. Overall there is a small but significant adverse impact of having advanced disease for women with diabetes that is found at the time of breast cancer diagnosis, and this may contribute to other inequities that occur in the treatment pathway that may impact on patient outcomes.

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Data availability

The data used for this study are not publicly available because of the ethics for patient information. They can be access through the National Breast Cancer Register and the Ministry of Health with appropriate ethics approval.

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Acknowledgments

We would like to acknowledge the Health Research Council of New Zealand for the financial support and Te Rēhita Mate Ūtaetae—Breast Cancer Foundation New Zealand National Register and the Ministry of Health for providing the detailed data.

Funding

This work was funded by the Health Research Council of New Zealand (Grant Number: 21/068).

Author information

Authors and Affiliations

  1. Medical Research Centre, The University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand

    Chunhuan Lao & Ross Lawrenson

  2. Department of Public Health, University of Otago, Wellington, New Zealand

    Jason Gurney, James Stanley & Andrea Teng

  3. Department of Medicine, University of Otago, Wellington, New Zealand

    Jeremy Krebs

  4. General Surgery, Wakefield Hospital, Wellington, New Zealand

    Ineke Meredith, Ian Campbell & Jonathan Koea

  5. School of Medicine, The University of Auckland, Auckland, New Zealand

    Ian Campbell

  6. Department of Pathology & Molecular Medicine, University of Otago, Wellington, New Zealand

    Dianne Sika-Paotonu

  7. Medical Surgery, The University of Auckland, Auckland, New Zealand

    Jonathan Koea

  8. Strategy and Funding, Waikato Hospital, Hamilton, New Zealand

    Ross Lawrenson

Authors
  1. Chunhuan Lao
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  2. Jason Gurney
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  3. James Stanley
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  4. Jeremy Krebs
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  5. Ineke Meredith
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  6. Ian Campbell
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  7. Andrea Teng
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  8. Dianne Sika-Paotonu
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  9. Jonathan Koea
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  10. Ross Lawrenson
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CL and RL. The first draft of the manuscript was written by CL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chunhuan Lao.

Ethics declarations

Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Ethics approval for the study was granted through the University of Waikato Human Research Ethics Committee (reference: HREC(Health)2021#89).

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Not applicable.

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Cite this article

Lao, C., Gurney, J., Stanley, J. et al. Association of diabetes and breast cancer characteristics at diagnosis. Cancer Causes Control 34, 103–111 (2023). https://doi.org/10.1007/s10552-022-01654-y

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  • DOI: https://doi.org/10.1007/s10552-022-01654-y

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