Medical Research Centre, The University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
Cancer Causes Control. 2023 Feb;34(2):103-111. doi: 10.1007/s10552-022-01654-y. Epub 2022 Nov 21.
This study aims to examine the association of diabetes and breast cancer characteristics at diagnosis in Aotearoa/New Zealand.
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.
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).
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.
本研究旨在探讨糖尿病与新西兰乳腺肿瘤特征在诊断时的关联。
从全国乳腺癌登记处确定了 2005 年至 2020 年间被诊断为浸润性乳腺癌的患者。使用逻辑回归模型估计患有 III-IV 期癌症的调整比值比（OR）和患有 IV 期癌症的 OR，比较患有糖尿病的女性与无糖尿病的女性。估计了 45-69 岁患有糖尿病的患者与无糖尿病的患者相比，其乳腺肿瘤经筛查检出的调整比值比（OR）。
共诊断出 26968 名女性患有乳腺癌，其中 3137 名（11.6%）患者在癌症诊断时患有糖尿病。糖尿病和乳腺癌同时发生的概率随时间增加。毛利人、太平洋岛民和亚裔女性比欧洲/其他族裔更有可能患有糖尿病。糖尿病的概率也随年龄增长而增加。对于患有糖尿病的患者，与无糖尿病的患者相比，患有 III-IV 期癌症和 IV 期癌症的概率更高（OR 1.14，95%CI 1.03-1.27；和 1.17，95%CI 1.00-1.38）。45-69 岁患有糖尿病的女性比无糖尿病的女性更有可能患有经筛查检出的癌症（OR 1.13，95%CI 1.02-1.26）。
糖尿病与乳腺癌同时发生的情况越来越常见。总体而言，患有糖尿病的女性在乳腺癌诊断时患有晚期疾病的风险较小，但具有显著的不利影响，这可能导致治疗过程中出现其他不平等现象，从而影响患者的预后。
