Pharmacologic Therapy of Diabetes and Overall Cancer Risk and Mortality: A Meta-Analysis of 265 Studies

Wu, Lang; Zhu, Jingjing; Prokop, Larry J.; Murad, M. Hassan

doi:10.1038/srep10147

Cited by 134 publications

(131 citation statements)

References 55 publications

(67 reference statements)

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“…A systematic review of observational studies suggested that diabetic patients on metformin have a reduction in the rate of CRC compared to their diabetic counterpart not on metformin [53, 62–64]. Furthermore, a multicenter double-blind, randomized controlled phase III trial found that non-diabetic patients who received metformin 250 mg daily were less likely to have metachronous adenomas 1 year after polypectomy compared to those who received placebo (RR 0.67; 95% CI 0.47–0.97) [65].…”

Section: Treatment Considerations In Diabetes-related Enteropathic DImentioning

confidence: 99%

Diabetes Mellitus and the Colon

Piper

Saad

2017

Curr Treat Options Gastro

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Opinion statement Diabetes mellitus (DM) can affect the structure and function of the colon promoting commonly encountered lower gastrointestinal symptoms such as constipation, diarrhea, abdominal distention, bloating, and abdominal pain. Specific colonic disorders for which adults with DM are at greater risk include chronic constipation, enteropathic diarrhea, colorectal cancer (CRC), inflammatory bowel disease, microscopic colitis, and Clostridium difficile colitis. Smooth muscle structure and function, density of the interstitial cells of Cajal, and the health and function of the autonomic and enteric nerves of the colon are all potential affected by DM. These effects can in turn lead to alterations in colon motility, visceral sensation, immune function, endothelial function, and the colonic microbiome. The evaluation and treatment for slow transit constipation as well as pelvic floor dysfunction should be considered when constipation symptoms are refractory to initial treatment measures. DM-related medications and small bowel conditions such as celiac disease and small intestinal bowel overgrowth should be considered and excluded before a diagnosis of enteropathic diarrhea is made. Given the higher risk of CRC, adults with DM should be appropriately screened and may require a longer bowel preparation to ensure an adequate evaluation.

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Section: Treatment Considerations In Diabetes-related Enteropathic DImentioning

confidence: 99%

Diabetes Mellitus and the Colon

Piper

Saad

2017

Curr Treat Options Gastro

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“…Increasing evidence has demonstrated the anticancer capacity of metformin. A recent meta-analysis by Wu et al (36) in 2015 evaluated the use of metformin in patients with type 2 diabetes and indicated that this use was associated with 14 and 30% reductions in the rates of cancer incidence and mortality, respectively. Furthermore, other meta-analyses (37-40) obtained similar results, suggesting an overall decrease in the risk of cancer by metformin.…”

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

Metformin use and its effect on gastric cancer in patients with type 2 diabetes: A systematic review of observational studies

Zhang

Gao

et al. 2017

Oncol Lett

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Abstract. Increasing evidence suggests that metformin use is associated with a decreased risk of cancer. The traditional therapies for gastric cancer (GC) are gastrectomy and chemoradiotherapy; however, these therapies may cause certain adverse effects, which affect a patient's quality of life, and the overall survival rate is low. At present, little is known about whether the use of metformin decreases the risk of GC in patients with type 2 diabetes. Therefore, in the present study, a systematic review was performed to analyze the effect of metformin on GC. A literature search was conducted in PubMed, EMBASE, and the Cochrane Library databases for articles published up to June 30th, 2016. The studies that evaluated GC patients treated with metformin and compared them with GC patients treated with other antidiabetic drugs were reviewed. Eligible studies were evaluated using the Newcastle-Ottawa Scale. Adjusted hazard ratio and 95% confidence intervals were determined to evaluate the effect of metformin on GC. From the 422 articles evaluated, 5 studies involving a total of 1,804,479 patients met the inclusion criteria and were qualitatively analyzed. The quality of all selected articles was classified as moderate. These studies reported that the long-term use of metformin was associated with a lower risk of GC compared with the lack of use of metformin or the use of other hypoglycemic drugs. In GC patients with diabetes who were subjected to gastrectomy, the cumulative use of metformin reduced the rates of disease recurrence and of all-cause and cancer-specific mortality. Despite the limited number of studies on this subject, currently available evidence indicates that metformin is associated with a decreased risk of GC and improves survival in patients with type 2 diabetes. However, more well-designed trials are required to elucidate this association.

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“…Epidemiologic studies in patients with diabetes highlighted a positive association between the chronic consumption of metformin and a decrease in the incidence of various types of cancer [85][86][87], data further supported by a meta-analysis that confirmed the reduction of cancer risk and mortality in patients treated with metformin [88], thus encouraging the potential oncological use of this drug. Metformin effects have been evaluated in preclinical studies on different solid tumor models, including breast [89,90], endometrial [91], pancreatic [70], lung [92], prostate [93], head and neck [94] carcinomas, glioma and neuroblastoma [95][96][97], and blood malignancies [98][99][100].…”

Section: Metforminmentioning

confidence: 88%