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    Cancer and Diabetes: Is There a Connection?

    It is unclear if diabetes makes a woman prone to breast cancer, but it may increase her risk of dying from it once diagnosed, according to Thomas A. Sellers, Ph.D., a Mayo Clinic cancer researcher who presented findings of the Iowa Women's Health Study at the American Diabetes Association's 60th Annual Scientific Sessions in San Antonio.

    Because obesity is a risk factor for both breast cancer and diabetes, the researchers hoped to find out if the excess metabolic profile in women with diabetes exacerbates risk, pushes them over the threshold and causes them to develop breast cancer. This five-year study followed more than 28,000 women between 1986 and 1992. Of the 2,675 women who had diabetes in the group, 611 or about 23 percent developed breast cancer over the course of the study and 92 of them died.

    Although the researchers did not note a higher incidence of breast cancer in women with diabetes than other women, what they did find out surprised them. The study, published in 1998 in the Journal of Epidemiology, found that the prognosis of women with diabetes and breast cancer is significantly worse than other breast cancer patients, and this was true especially for those with a family history of breast cancer who are extremely obese.

    A high hip-to-waist ratio increased the risk for death five-fold in women with diabetes, but no family history of breast cancer, and nine-fold in women with a family history. A high body mass index (BMI) or high amount of abdominal fat tissue increased the risk for death six-fold in women with diabetes and no family history of breast cancer, and 15-fold in women with a family history. The risk for death increased 10-fold in women with diabetes and both obesity risk factors but no family history. However, mortality increased 25-fold in breast cancer patients with diabetes and all three risk factors.

    Diabetes probably won't increase your risk for colorectal or prostate cancer either, but the incidence of these cancers goes up in men the longer they've had diabetes, according to Julie C. Will, MPH, PhD, a researcher at the Centers for Disease Control in Atlanta.

    Looking for a connection between cancer and diabetes, Dr. Will analyzed data from a 13-year American Cancer Society Cancer Prevention study (1959-1972) that involved about one million participants. She found a slightly higher rate of colorectal cancer among people with diabetes -- greater in men than women. Likewise, there appeared to be a greater risk for prostate cancer among men who had had diabetes the longest. She noted however, that this finding is unclear because older age is the strongest risk factor for prostate cancer, and the men who had had diabetes the longest tended to be older than those more recently diagnosed.

    What was interesting about her study is that participants who ate their Wheaties, drank milk, took aspirin and exercised even minimally were the least likely to develop colorectal cancer, regardless of whether or not they had diabetes. In fact, each glass of milk consumed daily appeared to reduce the risk for colorectal cancer by four percent in women and eight percent in men, said Will, noting that the incidence for both colorectal and prostate was highest in men who ate cooked vegetables, smoked and had a college education. She offered no explanation for why better-educated men appear to be at increased risk for cancer.



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