title: Impaired glucose metabolism and diabetes and the risk of breast, endometrial, and ovarian cancer.
abstract: BACKGROUND
  Epidemiological evidence indicates that individuals with type 2 diabetes are at an increased risk of cancer. Elevated glucose levels, below the diagnostic threshold for diabetes, have also been suggested to be associated with increased cancer risks.
  
  
  METHODS
  We investigated possible associations between glucose levels and the risk of breast, endometrial, and ovarian cancer in a cohort of more than 230,000 women, for which information on outcome and potential confounders was obtained by record linkage to population-based registers.
  
  
  RESULTS
  Diabetes was associated with an increased risk of postmenopausal breast cancer (HR = 1.22, 95% CI 1.04-1.43). An indication of a slightly elevated breast cancer risk was also found in postmenopausal women with impaired glucose metabolism (HR = 1.11, 95% CI 0.96-1.28). Diabetes (HR = 1.46, 95% CI 1.09-1.96) and impaired glucose metabolism (HR = 1.41, 95% CI 1.08-1.85) were associated with an increased risk of endometrial cancer. No associations were found between glucose levels and ovarian cancer risk. Following adjustment for BMI, estimates were attenuated for endometrial cancer, while point estimates for breast and ovarian cancer remained essentially unchanged.
  
  
  CONCLUSIONS
  Our results indicate that glucose levels below the diagnostic threshold for diabetes modify the risk not only of endometrial cancer but possibly also of postmenopausal breast cancer.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm. Sweden. Mats.Lambe@ki.se
authors.forename: Mats
authors.initials: M
authors.lastname: Lambe
authors.forename: Annette
authors.initials: A
authors.lastname: Wigertz
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Göran
authors.initials: G
authors.lastname: Walldius
authors.forename: Ingmar
authors.initials: I
authors.lastname: Jungner
authors.forename: Niklas
authors.initials: N
authors.lastname: Hammar
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000378:metabolism; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000378:metabolism; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D005947:Glucose