Hormonal Therapy for Breast Cancer and Diabetes Incidence Among Postmenopausal Women
A partir des données des registres américains des cancers et de la base Medicare portant sur des patientes atteintes d'un cancer du sein de stade I à III (âge supérieur à 65 ans), cette étude évalue l'association entre une hormonothérapie par inhibiteurs de l'aromatase ou par tamoxifène et le risque de diabète
Purpose : The purpose of this study was to evaluate associations between hormonal therapy for breast cancer and subsequent diabetes incidence. Methods : The Surveillance, Epidemiology and End Results (SEER) – Medicare linked data was used. Stage I-III breast cancer patients diagnosed at 65+ years who filled at least two prescriptions for an aromatase inhibitor (AI) or tamoxifen by the end of 2008, and within 12 months of breast cancer diagnosis, were selected. Women without cancer from a 5% random sample of Medicare beneficiaries were frequency matched to patients by age group and new onset diabetes was monitored for twenty-four months post-baseline in both groups of women. Results : Cox proportional hazards analysis failed to show an association between AI use and subsequent diabetes onset after adjusting for age, race, and comorbidity (Hazard Ratio: 0.99; 95% Confidence Interval: 0.84 to 1.18). This study also failed to show an association between tamoxifen use and diabetes onset (Hazard Ratio: 0.79; 95% Confidence Interval: 0.54 to 1.17). Conclusions : Study findings provide evidence that postmenopausal AI and tamoxifen users do not experience an increased risk of diabetes in the two years following treatment initiation. Whether these findings will hold with longer duration follow up deserves a closer look.