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Cancer Causes & Control

, Volume 30, Issue 10, pp 1057–1065 | Cite as

Type 2 diabetes and obesity in midlife and breast cancer risk in the Reykjavik cohort

  • Gertraud MaskarinecEmail author
  • Álfheiður Haraldsdóttir
  • Kristjana Einarsdóttir
  • Thor Aspelund
  • Laufey Tryggvadóttir
  • Tamara B. Harris
  • Vilmundur Gudnason
  • Jóhanna E. Torfadóttir
Original Paper

Abstract

Purpose

As obesity and type 2 diabetes (T2D) have been increasing worldwide, we investigated their association with breast cancer incidence in the Reykjavik Study.

Methods

During 1968–1996, approximately 10,000 women (mean age = 53 ± 9 years) completed questionnaires and donated blood samples. T2D status was classified according to self-report (n = 140) and glucose levels (n  = 154) at cohort entry. A linkage with the Icelandic Cancer Registry provided breast cancer incidence through 2015. Cox regression with age as time metric and adjusted for known confounders was applied to obtain hazard ratios (HR) and 95% confidence intervals (CI).

Results

Of 9,606 participants, 294 (3.1%) were classified as T2D cases at cohort entry while 728 (7.8%) women were diagnosed with breast cancer during 28.4 ± 11.6 years of follow-up. No significant association of T2D (HR 0.95; 95% CI 0.56–1.53) with breast cancer incidence was detected except among the small number of women with advanced breast cancer (HR 3.30; 95% CI 1.13–9.62). Breast cancer incidence was elevated among overweight/obese women without (HR 1.18; 95% CI 1.01–1.37) and with T2D (HR 1.35; 95% CI 0.79–2.31). Height also predicted higher breast cancer incidence (HR 1.03; 95% CI 1.02–1.05). All findings were confirmed in women of the AGES–Reykjavik sub-cohort (n  = 3,103) who returned for an exam during 2002–2006. With a 10% T2D prevalence and 93 incident breast cancer cases, the HR for T2D was 1.18 (95% CI 0.62–2.27).

Conclusions

These findings in a population with low T2D incidence suggest that the presence of T2D does not confer additional breast cancer risk and confirm the importance of height and excess body weight as breast cancer risk factors.

Keywords

Breast cancer Type 2 diabetes Obesity Anthropometry Prospective cohort Cox regression 

Notes

Acknowledgments

The AGES–Reykjavik Study was funded by NIH contract N01-AG-12100, the Intramural Research Program of the National Institute on Aging, the Icelandic Heart Association, and the Icelandic Parliament. This work was also supported by the Icelandic Centre for Research, RANNIS Grant Number: 152495051, https://en.rannis.is/ (to AH), and the Public Health Fund of the Icelandic Directorate of Health (to AH). GM was funded by a Fulbright Global Scholar Award (2017–2018).

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gertraud Maskarinec
    • 1
    Email author
  • Álfheiður Haraldsdóttir
    • 2
    • 3
  • Kristjana Einarsdóttir
    • 2
  • Thor Aspelund
    • 2
  • Laufey Tryggvadóttir
    • 4
    • 5
  • Tamara B. Harris
    • 6
  • Vilmundur Gudnason
    • 7
  • Jóhanna E. Torfadóttir
    • 2
  1. 1.University of Hawaii Cancer CenterHonoluluUSA
  2. 2.Centre of Public Health Sciences, Faculty of MedicineUniversity of IcelandReykjavikIceland
  3. 3.Faculty of Food Science and Human NutritionUniversity of IcelandReykjavikIceland
  4. 4.The Icelandic Cancer RegistryReykjavikIceland
  5. 5.Faculty of MedicineUniversity of IcelandReykjavikIceland
  6. 6.Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on AgingNational Institutes of HealthBethesdaUSA
  7. 7.The Icelandic Heart AssociationKopavogurIceland

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