| アブストラクト | OBJECTIVE: Meta-analyses of epidemiologic studies have suggested that metformin may reduce cancer incidence, but randomized controlled trials did not support this hypothesis. RESEARCH DESIGN AND METHODS: A retrospective cohort study, Clinical Practice Research Datalink, was designed to investigate the association between use of metformin compared with other antidiabetes medications and cancer risk by emulating an intention-to-treat analysis as in a trial. A total of 95,820 participants with type 2 diabetes who started taking metformin and other oral antidiabetes medications within 12 months of their diagnosis (initiators) were followed up for first incident cancer diagnosis without regard to any subsequent changes in pharmacotherapy. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HR) and 95% CI. RESULTS: A total of 51,484 individuals (54%) were metformin initiators and 18,264 (19%) were sulfonylurea initiators, and 3,805 first incident cancers were diagnosed during a median follow-up time of 5.1 years. Compared with initiators of sulfonylurea, initiators of metformin had a similar incidence of total cancer (HR 0.96; 95% CI 0.89-1.04) and colorectal (HR 0.92; 95% CI 0.76-1.13), prostate (HR 1.02; 95% CI 0.83-1.25), lung (HR 0.85; 95% CI 0.68-1.07), or postmenopausal breast (HR 1.03; 95% CI 0.82-1.31) cancer or any other cancer. CONCLUSIONS: In this large study, individuals with diabetes who used metformin had a similar risk of developing cancer compared with those who used sulfonylureas. |
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| 投稿者 | Tsilidis, Konstantinos K; Capothanassi, Despoina; Allen, Naomi E; Rizos, Evangelos C; Lopez, David S; van Veldhoven, Karin; Sacerdote, Carlotta; Ashby, Deborah; Vineis, Paolo; Tzoulaki, Ioanna; Ioannidis, John P A |
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| 組織名 | Department of Hygiene and Epidemiology, University of Ioannina School of;Medicine, Ioannina, Greece Cancer Epidemiology Unit, University of Oxford,;Oxford, U.K. ktsilidi@cc.uoi.gr ktsilidis@gmail.com.;Medicine, Ioannina, Greece.;Clinical Trial Service Unit, University of Oxford, Oxford, U.K.;Lipid Disorders Clinic, Department of Internal Medicine, University Hospital of;Ioannina, Ioannina, Greece.;Division of Epidemiology, University of Texas School of Public Health, Houston,;TX.;Department of Epidemiology and Biostatistics, School of Public Health, Imperial;College London, St Mary's Campus, London, U.K. University College London;Institute of Child Health, Centre for Paediatric Epidemiology and Biostatistics,;London, U.K.;Human Genetics Foundation (HuGeF), Turin, Italy.;Imperial Clinical Trials Unit, School of Public Health, Imperial College London,;St Mary's Hospital, London, U.K.;College London, St Mary's Campus, London, U.K. Human Genetics Foundation (HuGeF),;Turin, Italy.;Medicine, Ioannina, Greece Department of Epidemiology and Biostatistics, School;of Public Health, Imperial College London, St Mary's Campus, London, U.K.;Stanford Prevention Research Center, Department of Medicine; Department of Health;Research and Policy, Stanford University School of Medicine; and Department of;Statistics, Stanford University School of Humanities and Sciences, Stanford, CA. |
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