Metformin Associated With Lower Cancer Mortality in Type 2 Diabetes
Top Cited Papers
Open Access
- 16 November 2009
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 33 (2), 322-326
- https://doi.org/10.2337/dc09-1380
Abstract
OBJECTIVE: Several studies have suggested an association between specific diabetes treatment and cancer mortality. We studied the association between metformin use and cancer mortality in a prospectively followed cohort. RESEARCH DESIGN AND METHODS: In 1998 and 1999, 1,353 patients with type 2 diabetes were enrolled in the Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) study in the Netherlands. Vital status was assessed in January 2009. Cancer mortality rate was evaluated using standardized mortality ratios (SMRs), and the association between metformin use and cancer mortality was evaluated with a Cox proportional hazards model, taking possible confounders into account. RESULTS: Median follow-up time was 9.6 years, average age at baseline was 68 years, and average A1C was 7.5%. Of the patients, 570 died, of which 122 died of malignancies. The SMR for cancer mortality was 1.47 (95% CI 1.22–1.76). In patients taking metformin compared with patients not taking metformin at baseline, the adjusted hazard ratio (HR) for cancer mortality was 0.43 (95% CI 0.23–0.80), and the HR with every increase of 1 g of metformin was 0.58 (95% CI 0.36–0.93). CONCLUSIONS: In general, patients with type 2 diabetes are at increased risk for cancer mortality. In our group, metformin use was associated with lower cancer mortality compared with nonuse of metformin. Although the design cannot provide a conclusion about causality, our results suggest a protective effect of metformin on cancer mortality.Keywords
This publication has 19 references indexed in Scilit:
- Antidiabetic Therapies Affect Risk of Pancreatic CancerGastroenterology, 2009
- Metformin use and prostate cancer in Caucasian men: results from a population-based case–control studyCancer Causes & Control, 2009
- Metformin and Pathologic Complete Responses to Neoadjuvant Chemotherapy in Diabetic Patients With Breast CancerJournal of Clinical Oncology, 2009
- Risk of malignancies in patients with diabetes treated with human insulin or insulin analogues: a cohort studyDiabetologia, 2009
- New Users of Metformin Are at Low Risk of Incident CancerDiabetes Care, 2009
- The antidiabetic drug metformin exerts an antitumoral effect in vitro and in vivo through a decrease of cyclin D1 levelOncogene, 2008
- Metformin and reduced risk of cancer in diabetic patientsBMJ, 2005
- Is Diabetes Mellitus Associated with Prostate Cancer Incidence and Survival?Epidemiology, 1999
- Excess Risk of Primary Liver Cancer in Patients With Diabetes MellitusJNCI Journal of the National Cancer Institute, 1996
- Mitogenic stimulation of human breast cancer cells in a growth factor‐defined medium: Synergistic action of insulin and estrogenJournal of Cellular Physiology, 1988