Is Hormone Therapy a Risk Factor for Diabetes in Breast Cancer Survivors?
Posted: Friday, June 15, 2018
Active hormone therapy appears to be linked to the development of diabetes in breast cancer survivors, reported a new case-cohort study published in the Journal of Clinical Oncology. Although the mechanism of this connection remains unclear, lead author Rola Hamood, MPH, of the University of Haifa, Israel, and colleagues stress the importance of lifestyle changes in patients who are more likely to develop the disease.
“Although cessation of treatment is not recommended because the survival benefits of hormone therapy outweigh the risks, preventive strategies aimed at lifestyle modifications may minimize the risk,” the authors concluded.
The investigators recruited 2,246 female survivors who were diagnosed with primary nonmetastatic invasive breast cancer between 2002 and 2012 from the Leumit health-care fund. A total of 324 women developed diabetes over an average of 5.9 years. Hormone therapy was associated with a greater risk of diabetes compared with no hormone therapy use (P = .008), but the risk associated with the use of tamoxifen was lower (hazard ratio = 2.25) than with the use of aromatase inhibitors (hazard ratio = 4.27). According to the authors, after excluding those with diabetes at the start of the study, the crude cumulative incidence rate of diabetes in the presence of death as a competing risk was 20.9%.
An increased risk of diabetes was reported in women treated with hormone therapy for over 1 year (hazard ratio = 2.36, P = .009). Patients were also at a greater risk of developing diabetes within 1 year of hormone therapy, although few cases existed.