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Cancer Causes Control. 2019 May;30(5):435-441. doi: 10.1007/s10552-019-01166-2. Epub 2019 Apr 4.

Diabetes and differences in detection of incident invasive breast cancer.

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Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 South Wood Street MC 871, Chicago, IL, 60612, USA.
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Departments of Epidemiology and Pharmacy, University of Washington, Seattle, WA, USA.
Baptist Memorial Health Care, Germantown, TN, USA.
Department of Medicine, New York University School of Medicine, New York, NY, USA.
Department of Population Health, New York University School of Medicine, New York, NY, USA.


Many women diagnosed with breast cancer have chronic conditions such as diabetes that may impact other health behaviors. Our purpose was to determine if breast cancer screening and detection differs among women with and without diabetes. We conducted a cross-sectional analysis of a retrospective cohort of women aged 52-74 years diagnosed with incident stages I-III breast cancer enrolled in an integrated health plan between 1999 and 2014 with linkage to the Surveillance, Epidemiology and End Results registry (n = 2040). Screening data were taken from electronic health records. We used multivariable modified Poisson regression models with robust standard errors to estimate relative risks (RR) and 95% confidence intervals (CI) for outcomes of (i) receipt of screening in the 2 years prior to diagnosis; (ii) symptom-detected breast cancer; and (iii) diagnosis of locally advanced stage III breast cancer. Compared to women without diabetes, women with diabetes were similar with respect to receipt of screening mammography (78% and 77%), symptom-detected breast cancer (46% and 49%), and stage III diagnosis (7% and 7%). In multivariable models adjusting for age and year of diagnosis, race, BMI, Charlson comorbidity score and depression diagnosis no differences were observed in the outcomes by presence of diabetes. Further investigation is warranted to determine how diabetes acts as a mediating factor in adverse breast cancer outcomes.


Breast cancer; Cancer screening; Diabetes; Mammography

[Available on 2020-05-01]
[Indexed for MEDLINE]

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