女性糖尿病病人乳癌發生率及其相關因素之研究

Incidence and Factors Associated with Breast Cancer in Women with Diabetes

目的：本研究旨在探討國內女性糖尿病病人乳癌之發生率及其相關因素。方法：使用國家衛生研究院發行之全民健康保險研究資料庫的2000 年百萬人抽樣歸人檔，以得到女性糖尿病病人罹患乳癌的資料。利用描述性統計、卡方檢定及邏輯斯迴歸進行分析。結果：糖尿病病人罹患乳癌之發生率為1.22%。影響50 歲以上女性糖尿病人是否罹患乳癌的因素有年齡層及投保地區都市化程度。相較於50-59 歲者，60-69 歲、70 歲（含）以上者罹患乳癌之勝算比為0.66、0.55；相較於城市者，在衛星市鎮、鄉村者罹患乳癌之勝算比為0.63、0.50，達統計顯著水準。結論：年齡及都市化程度是50 歲以上女性糖尿病病人罹患乳癌的危險因素，建議對高危群女性糖尿病人應加強宣導定期篩檢，以達早期發現早期治療之目標。

Objectives: To determine the incidence, personal attributes, and risk factors for breast cancer in female diabetic patients. Methods: This study was conducted with nationwide claims data for the year 2000 from the National Health Research Database in Taiwan. The National Health Insurance Database from 2002-2010 was used for analysis. Patients > 50 years of age and with ICD- 9-CM diagnosis code 250 or A-Code A181 were included. The exclusion criteria were previously diagnosed breast cancer and malignant neoplasms during the period from 2000-2002. The research cohort was comprised of 11,923 diabetics. A chi-square test and multiple logistic regression were used for data analysis. Results: The incidence of breast cancer in women with diabetes was 1.22%. Age and degree of urbanization stratification were significantly correlated with women with breast cancer ≥ 50 years of age. Compared with women 50-59 years of age, the odds ratio of having breast cancer for women 60-69 and > 70 years of age were 0.66 and 0.55, respectively; both odds ratios reached statistical signifi cance level. Compared with metropolitan dwellers, the odds ratios of having breast cancer for women living in satellite townships and rural areas were 0.63 and 0.50, respectively; both odds ratios reached a statistical signifi cance level. Conclusions: The main risk factors for breast cancer in women > 50 years of age with diabetes were age and urbanization stratifi cation. The present study suggested that health policy makers should encourage women > 50 years of age with diabetes to regularly undergo mammography screening to ensure early detection and treatment of breast cancer.