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Risk of breast cancer by individual insulin use: an international multicenter study.

Grimaldi-Bensouda, Lamiae and Cameron, David and Marty, Michel and Barnett, Anthony H and Penault-Llorca, Frédérique and Pollak, Michael and Charbonnel, Bernard and Riddle, Matthew and Mignot, Laurent and Boivin, Jean-François and Khachatryan, Artak and Rossignol, Michel and Bénichou, Jacques and Alpérovitch, Annick and Abenhaim, Lucien (2014) Risk of breast cancer by individual insulin use: an international multicenter study. Diabetes care, 37 (1). pp. 134-43. ISSN 1935-5548. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs

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Official URL: http://care.diabetesjournals.org/content/37/1/134....

Abstract

OBJECTIVE Several studies have been published in 2009 suggesting a possible association between insulin glargine and increased risk of malignancies, including breast cancer. The objective of this study was to assess the relation between the individual insulins (glargine, aspart, lispro, and human insulin) and development of breast cancer. RESEARCH DESIGN AND METHODS Seven hundred seventy-five incident cases of primary invasive or in situ carcinoma breast cancer occurring in women with diabetes from 92 centers in the U.K., Canada, and France were matched to a mean of 3.9 diabetic community control subjects (n = 3,050; recruited from 580 general practices) by country, age, recruitment date, and diabetes type and management. The main risk model was a multivariate conditional logistic regression model with case/control status as the dependent variable and individual insulin use, 8 years preceding the index date, as the independent variable, controlling for past use of any insulin, oral antidiabetes drugs, reproductive factors, lifestyle, education, hormone replacement therapy and history of contraceptive use, BMI, comorbidities, diabetes duration, and annual number of physician visits. Glargine was also compared with every other insulin by computing all ratios using the variance-covariance matrix of logistic model parameters. RESULTS Adjusted odds ratios of breast cancer for each type of insulin versus no use of that insulin were 1.04 (95% CI 0.76-1.44) for glargine, 1.23 (0.79-1.92) for lispro, 0.95 (0.64-1.40) for aspart, and 0.81 (0.55-1.20) for human insulin. Two-by-two comparisons found no difference between glargine and the different types of insulins. Insulin dosage or duration of use and tumor stage did not change the results. CONCLUSIONS This international study found no difference in the risk of developing breast cancer in patients with diabetes among the different types of insulin with short- to mid-term duration of use. Longer-term studies would be of interest.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Subjects: QZ Pathology. Oncology
WK Endocrine system. Endocrinology
WP Gynaecology. Women’s health
Divisions: Ambulatory Care > Diabetes
Related URLs:
Depositing User: Sophie Rollason
Date Deposited: 26 Jun 2014 08:46
Last Modified: 26 Jun 2014 08:46
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/343

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