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Meta-Analysis
. 2012 Oct 23;107(9):1608-17.
doi: 10.1038/bjc.2012.414. Epub 2012 Sep 20.

Diabetes and breast cancer risk: a meta-analysis

P Boyle  1 , M Boniol, A Koechlin, C Robertson, F Valentini, K Coppens, L-L Fairley, M Boniol, T Zheng, Y Zhang, M Pasterk, M Smans, M P Curado, P Mullie, S Gandini, M Bota, G B Bolli, J Rosenstock, P Autier
Affiliations
Meta-Analysis

Diabetes and breast cancer risk: a meta-analysis

P Boyle et al. Br J Cancer. .

Abstract

Background: The potential of an increased risk of breast cancer in women with diabetes has been the subject of a great deal of recent research.

Methods: A meta-analysis was undertaken using a random effects model to investigate the association between diabetes and breast cancer risk.

Results: Thirty-nine independent risk estimates were available from observational epidemiological studies. The summary relative risk (SRR) for breast cancer in women with diabetes was 1.27 (95% confidence interval (CI), 1.16-1.39) with no evidence of publication bias. Prospective studies showed a lower risk (SRR 1.23 (95% CI, 1.12-1.35)) than retrospective studies (SRR 1.36 (95% CI, 1.13-1.63)). Type 1 diabetes, or diabetes in pre-menopausal women, were not associated with risk of breast cancer (SRR 1.00 (95% CI, 0.74-1.35) and SRR 0.86 (95% CI, 0.66-1.12), respectively). Studies adjusting for body mass index (BMI) showed lower estimates (SRR 1.16 (95% CI, 1.08-1.24)) as compared with those studies that were not adjusted for BMI (SRR 1.33 (95% CI, 1.18-1.51)).

Conclusion: The risk of breast cancer in women with type 2 diabetes is increased by 27%, a figure that decreased to 16% after adjustment for BMI. No increased risk was seen for women at pre-menopausal ages or with type 1 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the literature search strategy to identify observational studies on breast cancer risk and diabetes.
Figure 2
Figure 2
Forest plot of meta-analysis of breast cancer in women with diabetes. Individual studies represented by relative risk (RR) and 95% confidence interval (CI).
Figure 3
Figure 3
Sensitivity analysis (leave-one-out) of meta-analysis of risk of breast cancer women with diabetes.
Figure 4
Figure 4
Forest plot of meta-analysis of breast cancer and diabetes in studies with relative risk (RR) adjusted for BMI. Individual studies represented by RR and 95% confidence interval (CI).
Figure 5
Figure 5
Forest plot of meta-analysis of breast cancer and diabetes in studies with relative risk (RR) not adjusted for BMI. Individual studies represented by RR and 95% confidence interval (CI).
Figure 6
Figure 6
Cumulative temporal meta-analysis of breast cancer risk in diabetic women.
See this image and copyright information in PMC

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