Improved prognosis in gastric adenocarcinoma among metformin users in a population-based study
- 10 May 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 125 (2), 277-283
- https://doi.org/10.1038/s41416-021-01408-8
Abstract
Background Metformin may improve the prognosis in gastric adenocarcinoma, but the existing literature is limited and contradictory. Methods This was a Swedish population-based cohort study of diabetes patients who were diagnosed with gastric adenocarcinoma in 2005–2018 and followed up until December 2019. The data were retrieved from four national health data registries: Prescribed Drug Registry, Cancer Registry, Patient Registry and Cause of Death Registry. Associations between metformin use before the gastric adenocarcinoma diagnosis and the risk of disease-specific and all-cause mortality were assessed using multivariable Cox proportional hazard regression. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for sex, age, calendar year, comorbidity, use of non-steroidal anti-inflammatory drugs or aspirin, and use of statins. Results Compared with non-users, metformin users had a decreased risk of disease-specific mortality (HR 0.79, 95% CI 0.67–0.93) and all-cause mortality (HR 0.78, 95% CI 0.68–0.90). The associations were seemingly stronger among patients of female sex (HR 0.66, 95% CI 0.49–0.89), patients with tumour stage III or IV (HR 0.71, 95% CI 0.58–0.88), and those with the least comorbidity (HR 0.71, 95% CI 0.57–0.89). Conclusions Metformin use may improve survival in gastric adenocarcinoma among diabetes patients.Keywords
Funding Information
- China Scholarship Council (201700260292)
- Cancerfonden (190043, 180684)
- Vetenskapsrådet (2019-00209)
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