Metformin and Cancer: Mounting Evidence Against an Association

Suissa, Samy; Azoulay, Laurent

doi:10.2337/dc14-0500

Cited by 91 publications

(88 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results were also described in many previous studies, in which metformin reduced overall risk of malignancy [9][10][11]. However, some authors did not found any protective effect of metformin on cancer development [12] or contests those associations due to the limitations of observational studies [13]. Nevertheless, a vast majority of evidence indicate reduced cancer risk among metformin users, which was confirmed in two large meta-analyses [4,14].…”

Section: Discussionsupporting

confidence: 73%

Antidiabetic medications use and cancer risk in type 2 diabetes

Dąbrowski

Szymańska‐Garbacz

Miszczyszyn

et al. 2017

Clinical Diabetology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 73%

Antidiabetic medications use and cancer risk in type 2 diabetes

Dąbrowski

Szymańska‐Garbacz

Miszczyszyn

et al. 2017

Clinical Diabetology

View full text Add to dashboard Cite

“…Although strong evidence supports the association of diabetes with crc, and recent work has examined metformin as a prognostic factor in crc, results are contradictory and tend to be related to specific patient populations [15][16][17][18][19] . In the present retrospective study, we set out to investigate whether metformin use in diabetic patients diagnosed with crc was associated with survival.…”

Section: Introductionmentioning

confidence: 97%

A Retrospective Study on the Role of Diabetes and Metformin in Colorectal Cancer Disease Survival

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In observational studies on the association of diabetes medication and cancer risk, several kinds of time-related bias may occur: immortal time bias, time-window bias, and time-lag bias (10,13,14). According to Suissa and Azoulay (10,13,14), a large number of studies are afflicted with the immortal time bias.…”

mentioning

confidence: 99%

Are Sulfonylurea and Insulin Therapies Associated With a Larger Risk of Cancer Than Metformin Therapy? A Retrospective Database Analysis

2014

View full text Add to dashboard Cite

OBJECTIVESeveral meta-analyses of observational studies suggested that metformin use reduces cancer risk in type 2 diabetes. However, this result was not confirmed by the few available randomized controlled trials (RCTs), and many observational studies on metformin and cancer were potentially afflicted with time-related bias. We aimed to avoid this bias when comparing cancer incidence in users of sulfonylurea, insulin, and other diabetes medications, respectively, with cancer incidence in metformin users. RESEARCH DESIGN AND METHODSIn a retrospective observational study, we used the German Disease Analyzer database with patient data from general practices throughout Germany. The study sample included 22,556 patients diagnosed with type 2 diabetes. During the median follow-up time of 4.8 years, 1,446 (6.4%) patients developed any cancer. In Cox regression analyses with either monotherapies or first diabetes medications as drug exposure, users of sulfonylurea (or insulin or other antidiabetes medications) were compared with metformin users. RESULTSIn multivariable adjusted models, hazard ratios were 1.09 (95% CI 0.87-1.36) for sulfonylurea monotherapy, 1.14 (95% CI 0.85-1.55) for insulin monotherapy, and 0.94 (95% CI 0.67-1.33) for other diabetes medications compared with metformin monotherapy. Results were similar for comparison of first diabetes medications. CONCLUSIONSIn a retrospective database analysis, taking into account potential time-related biases, no reduced cancer risk was found in metformin users. To clarify the association between diabetes medication and cancer risk, further well-designed observational studies and RCTs are needed.From meta-analyses, there is evidence that type 2 diabetes is associated with an increased risk of cancer (1-4). Antidiabetes medication may modify cancer risk in patients with type 2 diabetes. Several meta-analyses suggested that metformin reduces the risk of cancer by approximately one-third (5-9). In one recent metaanalysis, for example, a 34% reduction in the incidence of any cancer and a 33%

show abstract

Metformin and Cancer: Mounting Evidence Against an Association

Cited by 91 publications

References 22 publications

Antidiabetic medications use and cancer risk in type 2 diabetes

Antidiabetic medications use and cancer risk in type 2 diabetes

A Retrospective Study on the Role of Diabetes and Metformin in Colorectal Cancer Disease Survival

Are Sulfonylurea and Insulin Therapies Associated With a Larger Risk of Cancer Than Metformin Therapy? A Retrospective Database Analysis

Contact Info

Product

Resources

About