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Impaired glucose metabolism and diabetes and the risk of breast, endometrial, and ovarian cancer

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Abstract

Background

Epidemiological evidence indicates that individuals with type 2 diabetes are at an increased risk of cancer. Elevated glucose levels, below the diagnostic threshold for diabetes, have also been suggested to be associated with increased cancer risks.

Methods

We investigated possible associations between glucose levels and the risk of breast, endometrial, and ovarian cancer in a cohort of more than 230,000 women, for which information on outcome and potential confounders was obtained by record linkage to population-based registers.

Results

Diabetes was associated with an increased risk of postmenopausal breast cancer (HR = 1.22, 95% CI 1.04–1.43). An indication of a slightly elevated breast cancer risk was also found in postmenopausal women with impaired glucose metabolism (HR = 1.11, 95% CI 0.96–1.28). Diabetes (HR = 1.46, 95% CI 1.09–1.96) and impaired glucose metabolism (HR = 1.41, 95% CI 1.08–1.85) were associated with an increased risk of endometrial cancer. No associations were found between glucose levels and ovarian cancer risk. Following adjustment for BMI, estimates were attenuated for endometrial cancer, while point estimates for breast and ovarian cancer remained essentially unchanged.

Conclusions

Our results indicate that glucose levels below the diagnostic threshold for diabetes modify the risk not only of endometrial cancer but possibly also of postmenopausal breast cancer.

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Acknowledgments

The study was supported by grants from the Swedish Council for Working life and Social research (# 2007-214), Karolinska Institutet Funds, the Swedish Cancer Society (# 2007/0526, # CAN 2010/608), and the Gunnar and Ingmar Jungner Foundation for Laboratory Medicine (Stockholm). The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden

    Mats Lambe

  2. Regional Oncologic Centre, Uppsala, Sweden

    Mats Lambe, Annette Wigertz & Hans Garmo

  3. Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Göran Walldius

  4. Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Göran Walldius & Niklas Hammar

  5. Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet and CALAB Research, Stockholm, Sweden

    Ingmar Jungner

  6. AstraZeneca R&D, Södertälje, Sweden

    Niklas Hammar

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  1. Mats Lambe
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Correspondence to Mats Lambe.

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Lambe, M., Wigertz, A., Garmo, H. et al. Impaired glucose metabolism and diabetes and the risk of breast, endometrial, and ovarian cancer. Cancer Causes Control 22, 1163–1171 (2011). https://doi.org/10.1007/s10552-011-9794-8

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  • DOI: https://doi.org/10.1007/s10552-011-9794-8

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