Metformin reduces ovarian cancer risk in Taiwanese women with type 2 diabetes mellitus
Journal
Diabetes/Metabolism Research and Reviews
Journal Volume
31
Journal Issue
6
Pages
619-626
Date Issued
2015
Author(s)
Abstract
Background: Whether metformin therapy affects ovarian cancer risk in Asian patients with type 2 diabetes mellitus has not been investigated. Methods: Data analysis was performed in 2014. The reimbursement databases of Taiwanese female patients with a new diagnosis of type 2 diabetes mellitus between 1998 and 2002 (n=479?475) were retrieved from the National Health Insurance for follow-up of ovarian cancer until the end of 2009. Metformin was treated as a time-dependent variable; and of these patients, 286?106 were never-users, and 193?369 were ever-users. A time-dependent approach was used to calculate ovarian cancer incidence and estimate hazard ratios by Cox regression for never-users (as referent group), ever-users and subgroups of metformin exposure (tertiles of cumulative duration and cumulative dose). Results: During follow-up, 601 metformin ever-users and 2600 never-users developed ovarian cancer, representing an incidence of 49.4 and 146.4 per 100?000 person-years, respectively. The overall fully adjusted hazard ratio (95% confidence intervals) for ever-users versus never-users was 0.658 (0.593-0.730). The fully adjusted hazard ratios for the first, second and third tertiles of cumulative duration of metformin therapy were 1.169 (1.019-1.341), 0.761 (0.644-0.898) and 0.276 (0.225-0.340), respectively (p trend<0.01) and 1.220 (1.067-1.395), 0.610 (0.513-0.725) and 0.305 (0.248-0.374), respectively (p trend<0.01), for a cumulative dose of metformin. In additional analyses, sulfonylureas but not the other antidiabetic drugs were associated with a reduced risk of ovarian cancer. Conclusions: Metformin use is associated with a decreased risk of ovarian cancer. ? 2015 John Wiley & Sons, Ltd.
SDGs
Other Subjects
antidiabetic agent; insulin; metformin; sulfonylurea derivative; antidiabetic agent; antineoplastic agent; metformin; sulfonylurea derivative; adult; Article; cancer incidence; controlled study; dependent variable; female; follow up; hazard ratio; human; major clinical study; middle aged; national health insurance; non insulin dependent diabetes mellitus; ovary cancer; priority journal; proportional hazards model; reimbursement; Taiwanese; aged; cohort analysis; complication; Diabetes Complications; Diabetes Mellitus, Type 2; dose response; electronic health record; incidence; national health service; Ovarian Neoplasms; prescription; risk factor; Taiwan; Adult; Aged; Anticarcinogenic Agents; Cohort Studies; Diabetes Complications; Diabetes Mellitus, Type 2; Dose-Response Relationship, Drug; Drug Prescriptions; Electronic Health Records; Female; Follow-Up Studies; Humans; Hypoglycemic Agents; Incidence; Metformin; Middle Aged; Ovarian Neoplasms; Proportional Hazards Models; Risk Factors; State Medicine; Sulfonylurea Compounds; Taiwan
Publisher
John Wiley and Sons Ltd
Type
journal article