Abstract
Methods: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. Results: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; Pinteraction = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (Pinteraction = 0.09). Conclusion: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. Impact: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.
Background: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in nonwhite populations.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 361-368 |
| Number of pages | 8 |
| Journal | Cancer Epidemiology Biomarkers and Prevention |
| Volume | 24 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2015 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Epidemiology
- Oncology
Cite this
Diabetes and other comorbidities in breast cancer survival by race/ethnicity : The California breast cancer survivorship consortium (CBCSC). / Wu, Anna H.; Kurian, Allison W.; Kwan, Marilyn L.; John, Esther M.; Lu, Yani; Keegan, Theresa H; Gomez, Scarlett Lin; Cheng, Iona; Shariff-Marco, Salma; Caan, Bette J.; Lee, Valerie S.; Sullivan-Halley, Jane; Tseng, Chiu Chen; Bernstein, Leslie; Sposto, Richard; Vigen, Cheryl.
In: Cancer Epidemiology Biomarkers and Prevention, Vol. 24, No. 2, 01.02.2015, p. 361-368.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diabetes and other comorbidities in breast cancer survival by race/ethnicity
T2 - The California breast cancer survivorship consortium (CBCSC)
AU - Wu, Anna H.
AU - Kurian, Allison W.
AU - Kwan, Marilyn L.
AU - John, Esther M.
AU - Lu, Yani
AU - Keegan, Theresa H
AU - Gomez, Scarlett Lin
AU - Cheng, Iona
AU - Shariff-Marco, Salma
AU - Caan, Bette J.
AU - Lee, Valerie S.
AU - Sullivan-Halley, Jane
AU - Tseng, Chiu Chen
AU - Bernstein, Leslie
AU - Sposto, Richard
AU - Vigen, Cheryl
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Methods: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. Results: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; Pinteraction = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (Pinteraction = 0.09). Conclusion: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. Impact: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.Background: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in nonwhite populations.
AB - Methods: We investigated the association of specific comorbidities with mortality in a multiethnic cohort of 8,952 breast cancer cases within the California Breast Cancer Survivorship Consortium (CBCSC), which pooled questionnaire and cancer registry data from five California-based studies. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Using multivariable Cox proportional hazards regression, we estimated HRs and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction. Results: Risk of breast cancer-specific mortality increased among breast cancer cases with a history of diabetes (HR, 1.48; 95% CI, 1.18-1.87) or myocardial infarction (HR, 1.94; 95% CI, 1.27-2.97). Risk patterns were similar across race/ethnicity (non-Latina white, Latina, African American, and Asian American), body size, menopausal status, and stage at diagnosis. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiotherapy nor chemotherapy (HR, 2.11; 95% CI, 1.32-3.36); no increased risk was observed among those who received both treatments (HR, 1.13; 95% CI, 0.70-1.84; Pinteraction = 0.03). A similar pattern was found for myocardial infarction by radiotherapy and chemotherapy (Pinteraction = 0.09). Conclusion: These results may inform future treatment guidelines for patients with breast cancer with a history of diabetes or myocardial infarction. Impact: Given the growing number of breast cancer survivors worldwide, we need to better understand how comorbidities may adversely affect treatment decisions and ultimately outcome.Background: The role of comorbidities in survival of patients with breast cancer has not been well studied, particularly in nonwhite populations.
UR - http://www.scopus.com/inward/record.url?scp=84922749733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922749733&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-14-1140
DO - 10.1158/1055-9965.EPI-14-1140
M3 - Article
C2 - 25425578
AN - SCOPUS:84922749733
VL - 24
SP - 361
EP - 368
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 2
ER -