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Am J Epidemiol. 2002 Aug 15;156(4):349-52.

Serum insulin and glucose levels and breast cancer incidence: the atherosclerosis risk in communities study.

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Division of Cancer Prevention and Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852, USA.


The authors examined the association of breast cancer incidence with serum levels of insulin and glucose in a cohort of 7,894 women aged 45-64 years from four US communities. Anthropometric factors and fasting levels of insulin and glucose were measured at baseline (1987-1989). Over an average follow-up period of 7.1 years (1987-1995), 187 breast cancer cases were ascertained. Breast cancer was associated positively with body mass index but not with waist:hip ratio or serum insulin level. After adjustment for age, race, and study site, the incidence of breast cancer was 60% higher among diabetic women than among women with fasting glucose levels under 100 mg/dl, but this association was attenuated after further adjustment for body mass index and other covariates (adjusted rate ratio = 1.39, 95% confidence interval: 0.86, 2.23). Circulating insulin levels were not predictive of future breast cancer incidence, but there may be a weak association with type 2 diabetes, perhaps modulated via increased adiposity.

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