Tags

Type your tag names separated by a space and hit enter

Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals.
BMC Cancer. 2011 Jan 18; 11:20.BC

Abstract

BACKGROUND

Metformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic cancers in a Taiwanese cohort.

METHODS

A representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration.

RESULTS

With diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident [hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79)]. There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤ 500 mg/day.

CONCLUSIONS

Metformin can reduce the incidences of several gastroenterological cancers in treated diabetes.

Authors+Show Affiliations

School of Public Health, National Defense Medical Center, Taipei, ROC. mmsl@ndmctsgh.edu.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21241523

Citation

Lee, Meei-Shyuan, et al. "Type 2 Diabetes Increases and Metformin Reduces Total, Colorectal, Liver and Pancreatic Cancer Incidences in Taiwanese: a Representative Population Prospective Cohort Study of 800,000 Individuals." BMC Cancer, vol. 11, 2011, p. 20.
Lee MS, Hsu CC, Wahlqvist ML, et al. Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer. 2011;11:20.
Lee, M. S., Hsu, C. C., Wahlqvist, M. L., Tsai, H. N., Chang, Y. H., & Huang, Y. C. (2011). Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer, 11, 20. https://doi.org/10.1186/1471-2407-11-20
Lee MS, et al. Type 2 Diabetes Increases and Metformin Reduces Total, Colorectal, Liver and Pancreatic Cancer Incidences in Taiwanese: a Representative Population Prospective Cohort Study of 800,000 Individuals. BMC Cancer. 2011 Jan 18;11:20. PubMed PMID: 21241523.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. AU - Lee,Meei-Shyuan, AU - Hsu,Chih-Cheng, AU - Wahlqvist,Mark L, AU - Tsai,Hsin-Ni, AU - Chang,Yu-Hung, AU - Huang,Yi-Chen, Y1 - 2011/01/18/ PY - 2010/03/02/received PY - 2011/01/18/accepted PY - 2011/1/19/entrez PY - 2011/1/19/pubmed PY - 2011/5/25/medline SP - 20 EP - 20 JF - BMC cancer JO - BMC Cancer VL - 11 N2 - BACKGROUND: Metformin protection against cancer risk in Orientals is uncertain. We examined the possible metformin effect on total, esophageal, gastric, colorectal (CRC), hepatocellular (HCC) and pancreatic cancers in a Taiwanese cohort. METHODS: A representative sample of 800,000 was drawn from the Taiwanese National Health Insurance data of 2000. A cohort of 480,984 participants 20 years or older, diabetes-cancer-free on 1st January 2000 was formed and categorized as four groups by DM and metformin usage status. Eligible incident cancer events had to occur one year after the index date until the end of 2007. The Cox proportional-hazards model evaluated relative risk of cancer for treated DM patients with or without metformin. The covariates included age, gender, other oral anti-hyperglycemic medication, Charlson comorbidity index (CCI) score and metformin exposure dosage and duration. RESULTS: With diabetes but no anti-hyperglycemic medication, cancer incidence density increased at least 2-fold for total, CRC and HCC. On metformin, total, CRC and HCC incidences decreased to near non-diabetic levels but to varying degrees depending on gender and cancer type (CRC in women, liver in men). Adjustment for other oral anti-hyperglycemic agents usage and CCI made the benefit of metformin more evident [hazard ratios (95% confidence intervals): total 0.12 (0.08-0.19), CRC 0.36 (0.13-0.98), liver 0.06 (0.02-0.16), pancreas 0.15 (0.03-0.79)]. There was a significant gender interaction with metformin in CRC which favored women. Metformin dosage for a significant decrease in cancer incidence was ≤ 500 mg/day. CONCLUSIONS: Metformin can reduce the incidences of several gastroenterological cancers in treated diabetes. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/21241523/Type_2_diabetes_increases_and_metformin_reduces_total_colorectal_liver_and_pancreatic_cancer_incidences_in_Taiwanese:_a_representative_population_prospective_cohort_study_of_800000_individuals_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-20 DB - PRIME DP - Unbound Medicine ER -