| アブストラクト | AIMS/HYPOTHESIS: The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. METHODS: National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112). By using a common data model and semi-aggregate approach, we pooled individual-level records from five cohorts and applied Poisson regression models. For each of ten cancer sites studied, we estimated the rate ratios (RRs) by duration (</=0.5, 0.5-1, 1-2, 2-3, 3-4, 4-5, 5-6 and >6 years) of cumulative exposure to insulin glargine or insulin detemir relative to that of human insulin. RESULTS: A total of 21,390 cancer cases occurred during a mean follow-up of 4.6 years. No trend with cumulative treatment time for insulin glargine relative to human insulin was observed in risk for any of the ten studied cancer types. Of the 136 associations tested in the main analysis, only a few increased and decreased risks were found: among women, a higher risk was observed for colorectal (RR 1.54, 95% CI 1.06, 2.25) and endometrial cancer (RR 1.78, 95% CI 1.07, 2.94) for </=0.5 years of treatment and for malignant melanoma for 2-3 years (RR 1.92, 95% CI 1.02, 3.61) and 4-5 years (RR 3.55, 95% CI 1.68, 7.47]); among men, a lower risk was observed for pancreatic cancer for 2-3 years (RR 0.34, 95% CI 0.17, 0.66) and for liver cancer for 3-4 years (RR 0.36, 95% CI 0.14, 0.94) and >6 years (RR 0.22, 95% CI 0.05, 0.92). Comparisons of insulin detemir with human insulin also showed no consistent differences. CONCLUSIONS/INTERPRETATION: The present multi-country study found no evidence of consistent differences in risk for ten cancers for insulin glargine or insulin detemir use compared with human insulin, at follow-up exceeding 5 years. |
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| 投稿者 | But, Anna; De Bruin, Marie L; Bazelier, Marloes T; Hjellvik, Vidar; Andersen, Morten; Auvinen, Anssi; Starup-Linde, Jakob; Schmidt, Marjanka K; Furu, Kari; de Vries, Frank; Karlstad, Oystein; Ekstrom, Nils; Haukka, Jari |
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| 組織名 | Department of Public Health Clinicum, University of Helsinki, Tukholmankatu 8B,;P.O. Box 20, 00014, Helsinki, Finland. anna.but@helsinki.fi.;Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG,;Utrecht, the Netherlands. M.L.deBruin@uu.nl.;Copenhagen Centre for Regulatory Science (CORS), Department of Pharmacy,;University of Copenhagen, Copenhagen, Denmark. M.L.deBruin@uu.nl.;Utrecht, the Netherlands.;Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo,;Norway.;Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden.;Research Unit of General Practice, University of Southern Denmark, Odense,;Denmark.;Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen,;Department of Epidemiology, School of Health Sciences, University of Tampere,;Tampere, Finland.;Department of Endocrinology and Internal Medicine, Aarhus University Hospital;THG, Aarhus, Denmark.;Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van;Leeuwenhoek Hospital, Amsterdam, the Netherlands.;Division of Psychosocial Research and Epidemiology, The Netherlands Cancer;Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.;The Netherlands Department of Clinical Pharmacy and Toxicology, Maastricht;University Medical Centre, Maastricht, the Netherlands.;The Netherlands Research Institute CAPHRI, Maastricht University, Maastricht, the;Netherlands.;The Netherlands MRC Lifecourse Epidemiology Unit, University of Southampton,;Southampton, UK.;P.O. Box 20, 00014, Helsinki, Finland. |
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