Highlights From The First World Congress on the Insulin Resistance Syndrome

Zachary T. Bloomgarden, MD

Disclosures

January 29, 2004

In This Article

The IRS and Malignancy

Rowan T. Chlebowski, MD, PhD, David Geffen School of Medicine at the University of California, Los Angeles, discussed lifestyle factors, such as obesity, caloric intake, and physical activity,[63,64,65] that may affect insulin resistance and cancer. Meta-analysis has shown a 1.56-fold increase in breast cancer associated with obesity.[66]

Pamela Goodwin, MD, University of Toronto, Ontario, Canada, further discussed the evidence for a relationship between insulin resistance and breast cancer.[67] Obesity,[68] particularly visceral obesity,[69] hyperinsulinemia,[70]hypertriglyceridemia,[71] PCOS,[72] and hyperglycemia,[73] are potential explanatory factors. Insulin resistance also is associated with worse breast cancer prognosis; overweight women have a 1.8- to 1.9-fold increased rate of recurrence and 1.4- to 1.6-fold increased mortality compared with women who are not overweight.[74] A number of trials of metformin treatment in breast cancer patients are planned.

Jing Ma, MD, PhD, Harvard Medical School, Boston Massachusetts, discussed the associations between insulin and the risk of colorectal cancer,[75] noting the "remarkable similarity" between the risk factors for type 2 diabetes and colon cancer. There are more than 50 studies suggesting an inverse association between physical activity and colon cancer, with a 30% to 50% risk reduction related to high activity.[76] More than 20 studies support an association between BMI and colon cancer. Finally, a number of studies have been carried out suggesting that type 2 diabetes is associated with a 1.5-fold increased risk of colon cancer.[77]

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