TY - JOUR
T1 - Metformin reduces the risk of cancer in patients with type 2 diabetes
AU - Kim, Hae Jin
AU - Lee, Soo Jin
AU - Chun, Ki Hong
AU - Jeon, Ja Young
AU - Han, Seung Jin
AU - Kim, Dae Jung
AU - Kim, Young Seol
AU - Woo, Jeong Taek
AU - Nam, Moon Suk
AU - Baik, Sei Hyun
AU - Ahn, Kyu Jeung
AU - Lee, Kwan Woo
N1 - Funding Information:
This study was supported by Korea Healthcare Technology, R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant no. HI10C2020).
Publisher Copyright:
© 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - The epidemiological literature suggests that insulin resistance, hyperinsulinemia, and increased levels of insulin-like growth factors place patients with type 2 diabetes mellitus (T2DM) at greater risk of cancer. The association between cancer incidence and the use of antidiabetic medications in patients with T2DM has been recently examined. There have been conflicting reports regarding an association between metformin and cancer risk. The aim of this study was to investigate the relationship between metformin use and the incidence of cancer in Koreans with T2DM. Data from The Korean National Diabetes Program (KNDP, 2006-2014), a nationwide, large-scale, prospective, multicenter cohort study in Korea, were used to study patients with T2DM. Patients ≥30 years old whose complete medical records were available were included in this study. Patients with a history of any cancer on KNDP registration or those who had been diagnosed with any type of cancer within 1 year of metformin use were excluded. Survival curves with respect to the incidence of cancer were plotted using the Kaplan-Meier method. Hazard ratios and 95% confidence intervals for cancer were estimated in a Cox proportional hazards regression analysis. During a mean 5.8 years of follow-up, 164 of the 1918 study patients (335 metformin nonusers and 1583 metformin users) developed cancer. The incidence per 1000 person-years was 21.8 in metformin nonusers and 13.2 in metformin users. Metformin users had a reduced risk of cancer, even after adjustment for demographic characteristics, metabolic parameters, diabetic complications, and other antidiabetic medications (hazard ratio 0.513, 95% confidence interval 0.318-0.826, P=.0060). Subgroup analysis of metformin users showed a reduced risk of cancer in males, patients<65 years of age, patients with a T2DM duration<5 years, nonobese patients, nonsmokers, and good glycemic control group. This large-scale, prospective, multicenter cohort study demonstrated an association between metformin use and reduced cancer risk in patients with T2DM.
AB - The epidemiological literature suggests that insulin resistance, hyperinsulinemia, and increased levels of insulin-like growth factors place patients with type 2 diabetes mellitus (T2DM) at greater risk of cancer. The association between cancer incidence and the use of antidiabetic medications in patients with T2DM has been recently examined. There have been conflicting reports regarding an association between metformin and cancer risk. The aim of this study was to investigate the relationship between metformin use and the incidence of cancer in Koreans with T2DM. Data from The Korean National Diabetes Program (KNDP, 2006-2014), a nationwide, large-scale, prospective, multicenter cohort study in Korea, were used to study patients with T2DM. Patients ≥30 years old whose complete medical records were available were included in this study. Patients with a history of any cancer on KNDP registration or those who had been diagnosed with any type of cancer within 1 year of metformin use were excluded. Survival curves with respect to the incidence of cancer were plotted using the Kaplan-Meier method. Hazard ratios and 95% confidence intervals for cancer were estimated in a Cox proportional hazards regression analysis. During a mean 5.8 years of follow-up, 164 of the 1918 study patients (335 metformin nonusers and 1583 metformin users) developed cancer. The incidence per 1000 person-years was 21.8 in metformin nonusers and 13.2 in metformin users. Metformin users had a reduced risk of cancer, even after adjustment for demographic characteristics, metabolic parameters, diabetic complications, and other antidiabetic medications (hazard ratio 0.513, 95% confidence interval 0.318-0.826, P=.0060). Subgroup analysis of metformin users showed a reduced risk of cancer in males, patients<65 years of age, patients with a T2DM duration<5 years, nonobese patients, nonsmokers, and good glycemic control group. This large-scale, prospective, multicenter cohort study demonstrated an association between metformin use and reduced cancer risk in patients with T2DM.
KW - cancer
KW - diabetes mellitus
KW - metformin
KW - type 2
UR - http://www.scopus.com/inward/record.url?scp=85042504491&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000010036
DO - 10.1097/MD.0000000000010036
M3 - Article
C2 - 29465545
AN - SCOPUS:85042504491
VL - 97
JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
SN - 0025-7974
IS - 8
M1 - e0036
ER -
