Human insulin does not increase bladder cancer risk
Journal
PLoS ONE
Journal Volume
9
Journal Issue
1
Pages
e86517
Date Issued
2014
Author(s)
Abstract
Background: Whether human insulin can induce bladder cancer is rarely studied. Methods: The reimbursement databases of all Taiwanese diabetic patients from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2004 and a total of 785,234 patients with type 2 diabetes were followed up for bladder cancer incidence until the end of 2009. Users of pioglitazone were excluded and the period since the initiation of insulin glargine (marketed after the entry date in Taiwan) was not included in the calculation of follow-up. Incidences for ever-users, never-users and subgroups of human insulin exposure (using tertile cutoffs of time since starting insulin, duration of therapy and cumulative dose) were calculated and the hazard ratios were estimated by Cox regression. Results: There were 87,940 ever-users and 697,294 never-users, with respective numbers of incident bladder cancer of 454 (0.52%) and 3,330 (0.48%), and respective incidence of 120.49 and 94.74 per 100,000 person-years. The overall hazard ratios (95% confidence intervals) indicated a significant association with insulin in the age-sex-adjusted models [1.238 (1.122-1.366)], but not in the model adjusted for all covariates [1.063 (0.951-1.187)]. There was also a significant trend for the hazard ratios for the different categories of the dose-response parameters in the age-sex-adjusted models, which became insignificant when all covariates were adjusted. Conclusions: This study relieves the concern of a bladder cancer risk associated with human insulin. Appropriate adjustment for confounders is important in the evaluation of cancer risk associated with a medication. ? 2014 Chin-Hsiao Tseng.
SDGs
Other Subjects
human insulin; insulin glargine; pioglitazone; recombinant human insulin; antidiabetic agent; human insulin; adult; aged; article; bladder cancer; cancer incidence; cancer risk; cohort analysis; controlled study; dose response; drug use; female; hazard ratio; human; major clinical study; male; non insulin dependent diabetes mellitus; proportional hazards model; retrospective study; Taiwan; Article; diabetic patient; disease duration; drug efficacy; drug exposure; drug safety; follow up; middle aged; national health insurance; non insulin dependent diabetes mellitus; reimbursement; Taiwanese; treatment duration; trend study; age; bladder; chemically induced; complication; Diabetes Mellitus, Type 2; factual database; incidence; pathology; risk factor; sex difference; Urinary Bladder Neoplasms; Adult; Age Factors; Aged; Databases, Factual; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Incidence; Insulin, Regular, Human; Male; Middle Aged; Proportional Hazards Models; Risk Factors; Sex Factors; Taiwan; Urinary Bladder; Urinary Bladder Neoplasms
Publisher
Public Library of Science
Type
journal article