Relation between diabetes, metformin treatment and the occurrence of malignancies in a Belgian primary care setting

Ngwana, Geraldine; Aerts, Marc; Carla, Truyers; Mathieu, Chantal; Bartholomeeusen, Stephaan; Wami, Welcome M.; Buntinx, Frank

doi:10.1016/j.diabres.2012.02.002

Cited by 26 publications

(17 citation statements)

References 19 publications

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“…Observations from two retrospective cohort studies from Belgium (4012 diabetic subjects) and China (7,950 diabetic subjects) were consistent with preceding reports, although the overall risks for cancer were slightly higher with HR 1.84 (95% CI; 1.51–2.24) [44] and SIR 1.331 (95% CI; 1.143–1.518) in men and 1.737 (95% CI; 1.478–1.997) in women [45]. According to inclusion criteria of most of studies, risk of cancer was evaluated among DMII patients, and cases of nonmelanoma skin cancer were excluded from the analysis.…”

Section: Epidemiologysupporting

confidence: 86%

Diabetes and Risk of Cancer

2013

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Diabetes and cancer represent two complex, diverse, chronic, and potentially fatal diseases. Cancer is the second leading cause of death, while diabetes is the seventh leading cause of death with the latter still likely underreported. There is a growing body of evidence published in recent years that suggest substantial increase in cancer incidence in diabetic patients. The worldwide prevalence of diabetes was estimated to rise from 171 million in 2000 to 366 million in 2030. About 26.9% of all people over 65 have diabetes and 60% have cancer. Overall, 8–18% of cancer patients have diabetes. In the context of epidemiology, the burden of both diseases, small association between diabetes and cancer will be clinically relevant and should translate into significant consequences for future health care solutions. This paper summarizes most of the epidemiological association studies between diabetes and cancer including studies relating to the general all-site increase of malignancies in diabetes and elevated organ-specific cancer rate in diabetes as comorbidity. Additionally, we have discussed the possible pathophysiological mechanisms that likely may be involved in promoting carcinogenesis in diabetes and the potential of different antidiabetic therapies to influence cancer incidence.

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Section: Epidemiologysupporting

confidence: 86%

Diabetes and Risk of Cancer

2013

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“…1 Between 2010 and 2030, the number of adults with diabetes in developing countries is expected to increase by 69%, and by 20% in developed countries. 2 3 In 2012, more than 400 000 cases of urinary bladder cancer (UBC) occurred worldwide, making it the seventh most common type of cancer. 4 It is more frequent in men than in women, and age is now widely accepted as the greatest single risk factor for developing UBC.…”

Section: Introductionmentioning

confidence: 99%

Risk of bladder cancer in patients with diabetes: a retrospective cohort study

et al. 2015

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ObjectiveThe objective of this study was to examine the association between diabetes, and both urinary bladder cancer (UBC) risk and mortality.MethodsWe conducted a retrospective cohort study using data from the UK Clinical Practice Research Datalink (CPRD) linked to the Office of National Statistics (ONS). Patients diagnosed with diabetes mellitus type 1 or 2, or using antidiabetic drugs (ADDs), were compared to matched non-diabetic controls. Cox proportional hazards models were used to estimate the risk and mortality of UBC. We adjusted for age, sex, smoking status and body mass index.ResultsThe cohort included 329 168 patients using ADD, and 307 315 controls with 1295 and 1071 patients, respectively, diagnosed as having UBC during follow-up. The adjusted HRs of UBC were 0.77 (95% CI 0.57 to 1.05) and 1.04 (95% CI 0.96 to 1.14) for type 1 and 2 diabetes, respectively. These results were similar if we restricted our analysis to an inception cohort. We noticed a small increased risk during the first year after diagnosis (HR=1.26 (95% CI 1.05 to 1.52)), which could be explained by detection bias. There was no influence of the severity of diabetes as measured by the glycated haemoglobin. Mortality of UBC was not increased for patients with either type 1 (HR=0.95 (95% CI 0.39 to 2.34)) or type 2 diabetes (HR=1.16 (95% CI 0.91 to 1.46)).ConclusionsNeither the risk of UBC nor the mortality from UBC was increased in patients with type 1 and patients with type 2 diabetes in the CPRD data.

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“…In several large population studies, DM or abnormal glucose metabolism was associated with an increased risk of CRC as well as several other neoplasms [1–5]. …”

Section: Introductionmentioning

confidence: 99%

Diabetes, metformin use, and colorectal cancer survival in postmenopausal women

Cossor

Adams‐Campbell²,

Chlebowski

et al. 2013

Cancer Epidemiology

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Background Observational studies have associated metformin use with lower colorectal cancer (CRC) incidence but few studies have examined metformin’s influence on CRC survival. We examined the relationships among metformin use, diabetes, and survival in postmenopausal women with CRC in the Women’s Health Initiative (WHI) Clinical Trials and Observational Study. Methods 2,066 postmenopausal women with CRC were followed for a median of 4.1 years, with 589 deaths after CRC diagnosis from all causes and 414 deaths directly attributed to CRC. CRC-specific survival was compared among women with diabetes with metformin use (n=84); women with diabetes with no metformin use (n=128); and women without diabetes (n=1854). Cox proportional hazard models were used to estimate associations among metformin use, diabetes and survival after CRC. Strategies to adjust for potential confounders included: multivariate adjustment with known predictors of colorectal cancer survival and construction of a propensity score for the likelihood of receiving metformin, with model stratification by propensity score quintile. Results After adjusting for age and stage, CRC specific survival in women with diabetes with metformin use was not significantly different compared to that in women with diabetes with no metformin use (HR 0.75; 95% CI 0.40 –1.38, p=0.67) and to women without diabetes (HR 1.00; 95% CI 0.61 – 1.66, p=0.99). Following propensity score adjustment, the HR for CRC-specific survival in women with diabetes with metformin use compared to non-users was 0.78 (95% CI 0.38 – 1.55, p=0.47) and for overall survival was 0.86 (95% CI 0.49 – 1.52; p=0.60). Conclusions In postmenopausal women with CRC and DM, no statistically significant difference was seen in CRC specific survival in those who used metformin compared to non-users. Analyses in larger populations of colorectal cancer patients are warranted.

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Relation between diabetes, metformin treatment and the occurrence of malignancies in a Belgian primary care setting

Cited by 26 publications

References 19 publications

Diabetes and Risk of Cancer

Diabetes and Risk of Cancer

Risk of bladder cancer in patients with diabetes: a retrospective cohort study

Diabetes, metformin use, and colorectal cancer survival in postmenopausal women

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