The Association of Metformin, Other Antidiabetic Medications, and Statins With the Prognosis of Colon Cancer in Patients With Type 2 Diabetes: A Retrospective Cohort Study

Abstract

Background Use of metformin and statins have been associated with improved prognosis of colon cancer (CC) in patients with type 2 diabetes (T2D). We examined the survival from CC in relation to the use of metformin, other oral antidiabetic medications (ADM), insulin, and statins in T2D patients. Materials and Methods A cohort (n = 2252) of persons with pre-existing T2D diagnosed with incident CC between 1998 and 2011 was identified from several Finnish registers. Cox models were fitted for cause-specific mortality rates to obtain adjusted estimates of the hazard ratios (HR) with 95% confidence intervals (CI) in relation to use of ADM and statins before the CC diagnosis. Cox models were also fitted for mortality in relation to post-diagnostic use of the medications treating these as time-dependent exposures, and starting follow-up 1 year after the CC diagnosis Results Pre- and post-diagnostic metformin use was weakly associated with the risk of CC–related death (HR .75; 95% CI .58-.99, and HR .78; 95% CI .54-1.14, respectively) compared to the use of other oral ADMs. Pre- and post-diagnostic statin use predicted a reduced risk of CC–related death (HR .83; 95% CI .71- .98, and HR .69; 95% CI .54-.89, respectively). Conclusion Additional evidence was found for use of statins being associated with an improved survival from CC in patients with pre-existing T2D, but for metformin use the evidence was weaker.

Association of metformin and statin uses with the prognosis of colon cancer: a meta-analysis

“…All data utilized for the meta-analysis can be located in Tables 1 and 2. A total of 19 studies (Garrett et al ., 2012; Lee et al , 2012; Cossor et al ., 2013; Spillane et al , 2013; Zanders et al , 2015; Mc Menamin Ú et al , 2016; Paulus et al , 2016; Zhu et al ., 2017; Al Omari et al ., 2018; Baglia et al ., 2019; Dulskas et al , 2019; Mafiana et al , 2019; Vernieri et al ., 2019; Huang et al ., 2020; Kaltenmeier et al ., 2021; Erkinantti et al ., 2022; Scarton et al ., 2022; Seo et al ., 2022; Tarhini et al , 2022) were identified, encompassing 41 832 participants, that assessed the correlation between metformin usage and prognostic-related outcomes. The study included 18 studies (Ng et al ., 2011; Lakha et al ., 2012; Nielsen et al , 2012; Cardwell et al , 2014; Krens et al ., 2014; Hoffmeister et al ., 2015; Shao et al ., 2015; Gray et al , 2016, 2017; Haukka et al , 2017; Lash et al ., 2017; Voorneveld et al ., 2017; Yokomichi et al ., 2017; Mafiana et al , 2019; Erkinantti et al ., 2022; Kim et al , 2022; Pourlotfi et al ., 2022) (including 382 441 participants) evaluating the association between statin use and prognostic-related outcomes.…”