University of Oulu

Hosio, M., Urpilainen, E., Hautakoski, A., Marttila, M., Arffman, M., Sund, R., Ahtikoski, A., Puistola, U., Karihtala, P., Jukkola, A., & Läärä, E. (2020). Survival after breast cancer in women with type 2 diabetes using antidiabetic medication and statins: a retrospective cohort study. Acta Oncologica, 59(9), 1110–1117.

Survival after breast cancer in women with type 2 diabetes using antidiabetic medication and statins : a retrospective cohort study

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Author: Hosio, Mayu1; Urpilainen, Elina2; Hautakoski, Ari3;
Organizations: 1Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 22, FIN-90029 Oulu, Finland
2Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland
3Research Unit of Mathematical Sciences, University of Oulu, P.O. Box 3000, FIN-90014 Oulu, Finland
4Orion Corporation, Orionintie 1, P.O. Box 65, FIN-02101 Espoo, Finland
5Service System Research Unit, Finnish Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland
6Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FIN-70211 Kuopio, Finland
7Cancer and Translational Medicine Research Unit, Department of Pathology, Oulu University Hospital and University of Oulu, P.O. Box 50, FIN-90029 Oulu, Finland
8Department of Oncology, University of Helsinki and Helsinki University Comprehensive Cancer Center, P.O.Box 180, FI-00029 Helsinki, Finland
9Department of Oncology and Radiotherapy, Cancer Centre Tampere, Tampere University Hospital, P.O. Box 2000, FIN-33521 Tampere, Finland
10Faculty of Medicine and Health Technology, Tampere University, P.O. Box 100, FIN-33014 Tampere University, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: Informa, 2020
Publish Date: 2021-06-01


Background/Objectives: We assessed survival of breast cancer in women with type 2 diabetes (T2D) treated with metformin, other types of antidiabetic medication (ADM) and statins.

Materials and methods: The study cohort consisted of women with T2D and diagnosed with breast cancer in Finland in 1998─2011. Mortality rates from breast cancer and other causes were analysed by Cox models, and adjusted hazard ratios (HRs) with 95% confidence intervals (Cls) were estimated in relation to the use of different types of medication.

Results: The final cohort consisted of 3,533 women. No clear evidence was found for breast cancer mortality being different in metformin users (HR 0.86, 95% Cl 0.63–1.17), but their other-cause mortality appeared to be lower (HR 0.73, 95% Cl 0.55–0.97) in comparison with women using other types of oral ADM. Other-cause mortality was higher among insulin users (HR 1.45, 95% Cl 1.16–1.80) compared with users of other oral ADMs, other than metformin. Prediagnostic statin use was observed to be associated with decreased mortality from both breast cancer (HR 0.76, 95% Cl 0.63–0.92) and other causes (HR 0.75, 95% Cl 0.64–0.87).

Conclusions: We did not find any association between ADM use and disease-specific mortality among women with T2D diagnosed with breast cancer. However, interestingly, prediagnostic statin use was observed to predict reduced mortality from breast cancer and other causes. We hypothesise that treating treatment practices of T2D or hypercholesterolaemia of breast cancer patients might affect overall prognosis of women diagnosed with breast cancer and T2D.

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Series: Acta oncologica
ISSN: 0284-186X
ISSN-E: 1651-226X
ISSN-L: 0284-186X
Volume: 59
Issue: 9
Pages: 1110 - 1117
DOI: 10.1080/0284186X.2020.1769858
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: This study was funded by grants from the Jane and Aatos Erkko Foundation, the Cancer Society of Finland, the Cancer Society of Northern Finland, the Finnish Association of Gynaecological Surgery, The Finnish Medical Foundation, Oulu Medical Research Foundation, The Finnish Society of Obstetrics and Gynaecology and Finnish Government Research Funds granted to the University Hospital of Oulu.
Copyright information: Copyright © 2021 Informa UK Limited. This is an Accepted Manuscript of an article published by Taylor & Francis in Acta Oncologica on 01 Jun 2020, available online: