TY - JOUR
T1 - Cancer risk associated with use of metformin and sulfonylurea in type 2 diabetes
T2 - A meta-analysis
AU - Soranna, Davide
AU - Scotti, Lorenza
AU - Zambon, Antonella
AU - Bosetti, Cristina
AU - Grassi, Guido
AU - Catapano, Alberico
AU - La Vecchia, Carlo
AU - Mancia, Giuseppe
AU - Corrao, Giovanni
PY - 2012
Y1 - 2012
N2 - Objective. Oral antidiabetic drugs (including metformin and sulfonylurea) may play a role in the relationship between type 2 diabetes and cancer. To quantify the association between metformin and sulfonylurea and the risk of cancer, we performed a meta-analysis of available studies on the issue. Materials and Methods. We performed a MEDLINE search for observational studies that investigated the risk of all cancers and specific cancer sites in relation to use of metformin and/or sulfonylurea among patients with type 2 diabetes mellitus. Fixed- and random-effect models were fitted to estimate the summary relative risk (RR). Betweenstudy heterogeneity was tested using Χ 2 statistics and measured with the I 2 statistic. Publication bias was evaluated using funnel plot and Egger's regression asymmetry test. Results. Seventeen studies satisfying inclusion criteria and including 37,632 cancers were evaluated after reviewing 401 citations. Use of metformin was associated with significantly decreased RR of all cancers (summary RR 0.61, 95% confidence interval [CI] 0.54-0.70), colorectal cancer (0.64, 95% CI 0.54 - 0.76), and pancreatic cancer (0.38, 95% CI 0.14-0.91). With the exception of colorectal cancer, significant between-study heterogeneity was observed. Evidence of publication bias for metformincancer association was also observed. There was no evidence that metformin affects the risk of breast and prostate cancers, nor that sulfonylurea affects the risk of cancer at any site. Conclusions. Metformin, but not sulfonylurea, appears to reduce subsequent cancer risk. This has relevant implications in light of the exploding global epidemic of diabetes.
AB - Objective. Oral antidiabetic drugs (including metformin and sulfonylurea) may play a role in the relationship between type 2 diabetes and cancer. To quantify the association between metformin and sulfonylurea and the risk of cancer, we performed a meta-analysis of available studies on the issue. Materials and Methods. We performed a MEDLINE search for observational studies that investigated the risk of all cancers and specific cancer sites in relation to use of metformin and/or sulfonylurea among patients with type 2 diabetes mellitus. Fixed- and random-effect models were fitted to estimate the summary relative risk (RR). Betweenstudy heterogeneity was tested using Χ 2 statistics and measured with the I 2 statistic. Publication bias was evaluated using funnel plot and Egger's regression asymmetry test. Results. Seventeen studies satisfying inclusion criteria and including 37,632 cancers were evaluated after reviewing 401 citations. Use of metformin was associated with significantly decreased RR of all cancers (summary RR 0.61, 95% confidence interval [CI] 0.54-0.70), colorectal cancer (0.64, 95% CI 0.54 - 0.76), and pancreatic cancer (0.38, 95% CI 0.14-0.91). With the exception of colorectal cancer, significant between-study heterogeneity was observed. Evidence of publication bias for metformincancer association was also observed. There was no evidence that metformin affects the risk of breast and prostate cancers, nor that sulfonylurea affects the risk of cancer at any site. Conclusions. Metformin, but not sulfonylurea, appears to reduce subsequent cancer risk. This has relevant implications in light of the exploding global epidemic of diabetes.
KW - Cancer
KW - Diabetes
KW - Meta-analysis
KW - Metformin
KW - Oral antidiabetic therapy
KW - Sulfonylurea
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U2 - 10.1634/theoncologist.2011-0462
DO - 10.1634/theoncologist.2011-0462
M3 - Article
C2 - 22643536
AN - SCOPUS:84862848716
VL - 17
SP - 813
EP - 822
JO - Oncologist
JF - Oncologist
SN - 1083-7159
IS - 6
ER -