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Metformin usage and the risk of colorectal cancer: a national cohort study.
Int J Colorectal Dis. 2021 Feb; 36(2):303-310.IJ

Abstract

PURPOSE

This study aimed to investigate the association between metformin usage and the risk of colorectal cancer (CRC) using data from the Korean National Health Insurance Service-National Health Screening Cohort database.

METHODS

Data from the NHIS-HEALS cohort between 2002 and 2015 were longitudinally analyzed. Subjects were divided into three groups: metformin non-users with diabetes mellitus (DM), metformin users with DM, and no DM group. CRC was defined using the ICD-10 code (C18.0-C20.0) at the time of admission. Cox proportional hazard regression models were adopted after stepwise adjustment for confounders to investigate the association between metformin usage and colorectal cancer risk.

RESULTS

During the follow-up period, of the total 323,430 participants, 2341 (1.33%) of the 175,495 males and 1204 (0.81%) of the 147,935 females were newly diagnosed with CRC. The estimated cumulative incidence of CRC was significantly different among the three groups based on Kaplan-Meier's survival curve (p values < 0.05 in both sexes). Compared with metformin non-users, hazard ratios (95% CIs) of metformin users and the no DM group were 0.66 (0.51-0.85) and 0.72 (0.61-0.85) in males and 0.59 (0.37-0.92) and 0.93 (0.66-1.29) in females, respectively, after being fully adjusted.

CONCLUSIONS

Metformin users with diabetes appear to have a significantly lower risk of CRC compared with metformin non-users.

Authors+Show Affiliations

Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.Department of Information & Statistics, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea.Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.Department of Information & Statistics, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea.Department of Information & Statistics, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea.Department of Information & Statistics, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea.Department of Information & Statistics, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, Republic of Korea. joungyoun@chungbuk.ac.kr.Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. kanght0818@gmail.com. Department of Family Medicine, Chungbuk National University College of Medicine, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do, 28644, Republic of Korea. kanght0818@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32968891

Citation

Lee, Jae-Woo, et al. "Metformin Usage and the Risk of Colorectal Cancer: a National Cohort Study." International Journal of Colorectal Disease, vol. 36, no. 2, 2021, pp. 303-310.
Lee JW, Choi EA, Kim YS, et al. Metformin usage and the risk of colorectal cancer: a national cohort study. Int J Colorectal Dis. 2021;36(2):303-310.
Lee, J. W., Choi, E. A., Kim, Y. S., Kim, Y., You, H. S., Han, Y. E., Kim, H. S., Bae, Y. J., Kim, J., & Kang, H. T. (2021). Metformin usage and the risk of colorectal cancer: a national cohort study. International Journal of Colorectal Disease, 36(2), 303-310. https://doi.org/10.1007/s00384-020-03765-x
Lee JW, et al. Metformin Usage and the Risk of Colorectal Cancer: a National Cohort Study. Int J Colorectal Dis. 2021;36(2):303-310. PubMed PMID: 32968891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metformin usage and the risk of colorectal cancer: a national cohort study. AU - Lee,Jae-Woo, AU - Choi,Eun-A, AU - Kim,Ye-Seul, AU - Kim,Yonghwan, AU - You,Hyo-Sun, AU - Han,Ye-Eun, AU - Kim,Hyeong-Seop, AU - Bae,Yoon-Jong, AU - Kim,Joungyoun, AU - Kang,Hee-Taik, Y1 - 2020/09/23/ PY - 2020/09/17/accepted PY - 2020/9/25/pubmed PY - 2021/6/24/medline PY - 2020/9/24/entrez KW - Colorectal cancer KW - Cox proportional hazard models KW - Diabetes KW - Kaplan-Meier estimate KW - Metformin SP - 303 EP - 310 JF - International journal of colorectal disease JO - Int J Colorectal Dis VL - 36 IS - 2 N2 - PURPOSE: This study aimed to investigate the association between metformin usage and the risk of colorectal cancer (CRC) using data from the Korean National Health Insurance Service-National Health Screening Cohort database. METHODS: Data from the NHIS-HEALS cohort between 2002 and 2015 were longitudinally analyzed. Subjects were divided into three groups: metformin non-users with diabetes mellitus (DM), metformin users with DM, and no DM group. CRC was defined using the ICD-10 code (C18.0-C20.0) at the time of admission. Cox proportional hazard regression models were adopted after stepwise adjustment for confounders to investigate the association between metformin usage and colorectal cancer risk. RESULTS: During the follow-up period, of the total 323,430 participants, 2341 (1.33%) of the 175,495 males and 1204 (0.81%) of the 147,935 females were newly diagnosed with CRC. The estimated cumulative incidence of CRC was significantly different among the three groups based on Kaplan-Meier's survival curve (p values < 0.05 in both sexes). Compared with metformin non-users, hazard ratios (95% CIs) of metformin users and the no DM group were 0.66 (0.51-0.85) and 0.72 (0.61-0.85) in males and 0.59 (0.37-0.92) and 0.93 (0.66-1.29) in females, respectively, after being fully adjusted. CONCLUSIONS: Metformin users with diabetes appear to have a significantly lower risk of CRC compared with metformin non-users. SN - 1432-1262 UR - https://www.unboundmedicine.com/medline/citation/32968891/Metformin_usage_and_the_risk_of_colorectal_cancer:_a_national_cohort_study_ L2 - https://doi.org/10.1007/s00384-020-03765-x DB - PRIME DP - Unbound Medicine ER -