Vol 68, No 6 (2017)
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Published online: 2017-09-22

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Use of metformin is associated with lower incidence of cancer in patients with type 2 diabetes

Alicja Muszyńska-Ogłaza, Grażyna Zarzycka-Lindner, Henryka Olejniczak, Mirosława Polaszewska-Muszyńska, Roman Junik
Pubmed: 29022647
Endokrynol Pol 2017;68(6):652-658.


Introduction: The objective of the study was to assess the influence of metformin on the prevalence of cancer and risk factors for the development of cancer, in patients with type 2 diabetes. Materials and methods: A total of 1063 patients, treated between October 2012 and March 2013 in the Diabetes and Endocrinology Centre in Bydgoszcz, were enrolled in the study. Only patients who were first diagnosed with diabetes and consecutively with cancer were included in the analysis. The final dataset compromised data from 1028 patients with type 2 diabetes, in whom retrospective analysis of the association between the occurrence of cancer and treatment with or without metformin was performed. Demographic data, medical history, physical assessment, diabetes history, diabetes complications, concomitant medication, and additional examination results were compared between two groups: those with cancer and those without cancer. Data were analysed using Student’s t-test, Chi-square test with Yates' continuity correction, and multiple logistic regression. Results: The most commonly observed cancer was breast cancer (24 patients; 22.5%), followed by uterine cancer (15 patients; 13.6%). Of the 75 diabetic patients with a cancer diagnosis, 18.7% were treated with metformin; of the 953 patients without cancer, 38% received metformin. Analysis of probability of cancer occurrence using Kaplan-Meier curves showed that the probability of cancer development was higher in groups of patients who were not treated with metformin (p = 0.006). Conclusions: Metformin treatment reduces the risk of cancer in type 2 diabetes patients.

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  1. Bowker SL, Pohar SL, Johnson JA. A cross-sectional study of health-related quality of life deficits in individuals with comorbid diabetes and cancer. Health Qual Life Outcomes. 2006; 4: 17.
  2. Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. CA Cancer J Clin. 2010; 60(4): 207–221.
  3. Michels KB, Solomon CG, Hu FB, et al. Nurses' Health Study. Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study. Diabetes Care. 2003; 26(6): 1752–1758.
  4. Coughlin SS, Calle EE, Teras LR, et al. Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol. 2004; 159(12): 1160–1167.
  5. Weiderpass E, Persson I, Adami HO, et al. Body size in different periods of life, diabetes mellitus, hypertension, and risk of postmenopausal endometrial cancer (Sweden). Cancer Causes Control. 2000; 11(2): 185–192.
  6. Maatela J, Aromaa A, Salmi T, et al. The risk of endometrial cancer in diabetic and hypertensive patients: a nationwide record-linkage study in Finland. Ann Chir Gynaecol Suppl. 1994; 208: 20–24.
  7. Hu FB, Manson JE, Liu S, et al. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst. 1999; 91(6): 542–547.
  8. Rosenfeld RG. Insulin-like growth factors and the basis of growth. N Engl J Med. 2003; 349(23): 2184–2186.
  9. Kim YI. Diet, lifestyle, and colorectal cancer: is hyperinsulinemia the missing link? Nutr Rev. 1998; 56(9): 275–279.
  10. Shaw RJ, Lamia KA, Vasquez D, et al. The kinase LKB1 mediates glucose homeostasis in liver and therapeutic effects of metformin. Science. 2005; 310(5754): 1642–1646.
  11. Ferrannini E. The Target of Metformin in Type 2 Diabetes. N Engl J Med. 2014; 371(16): 1547–1548.
  12. Madiraju AK, Erion DM, Rahimi Y, et al. Metformin suppresses gluconeogenesis by inhibiting mitochondrial glycerophosphate dehydrogenase. Nature. 2014; 510(7506): 542–546.
  13. Evans JMM, Donnelly LA, Emslie-Smith AM, et al. Metformin and reduced risk of cancer in diabetic patients. BMJ. 2005; 330(7503): 1304–1305.
  14. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998; 352(9131): 854–865.
  15. Margel D, Urbach D, Lipscombe LL, et al. Association between metformin use and risk of prostate cancer and its grade. J Natl Cancer Inst. 2013; 105(15): 1123–1131.
  16. International Statistical Classification of Diseases and Related Health Problems 10th Revision. http://apps.who.int/classifications/icd10/browse/2015/en (2015).
  17. Zakikhani M, Dowling R, Fantus IG, et al. Metformin is an AMP kinase-dependent growth inhibitor for breast cancer cells. Cancer Res. 2006; 66(21): 10269–10273.
  18. Alimova IN, Liu B, Fan Z, et al. Metformin inhibits breast cancer cell growth, colony formation and induces cell cycle arrest in vitro. Cell Cycle. 2009; 8(6): 909–915.
  19. Liu B, Fan Z, Edgerton SM, et al. Metformin induces unique biological and molecular responses in triple negative breast cancer cells. Cell Cycle. 2009; 8(13): 2031–2040.
  20. Currie CJ, Poole CD, Gale EAM. The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia. 2009; 52(9): 1766–1777.
  21. Viollet B, Guigas B, Sanz Garcia N, et al. Cellular and molecular mechanisms of metformin: an overview. Clin Sci (Lond). 2012; 122(6): 253–270.
  22. Bowker SL, Majumdar SR, Veugelers P, et al. Increased cancer-related mortality for patients with type 2 diabetes who use sulfonylureas or insulin. Diabetes Care. 2006; 29(2): 254–258.
  23. Monami M, Lamanna C, Balzi D, et al. Sulphonylureas and cancer: a case-control study. Acta Diabetol. 2009; 46(4): 279–284.
  24. Wright JL, Stanford JL. Metformin use and prostate cancer in Caucasian men: results from a population-based case-control study. Cancer Causes Control. 2009; 20(9): 1617–1622.
  25. Landman GWD, Kleefstra N, van Hateren KJJ, et al. Metformin associated with lower cancer mortality in type 2 diabetes: ZODIAC-16. Diabetes Care. 2010; 33(2): 322–326.
  26. Łukasiewicz D, Jakubowska I, Pędich-Czaban M. Analysis of the occurrence of cancers in patients with diabetes mellitus type 2. Diabetologia Kliniczna. 2012; 5: 177–184.
  27. Sieradzki J, Koblik T, Nazar M. Progress in treatment for type 2 diabetes mellitus based on HbA1c screening in 2002 and 2005. Diabetologia Praktyczna. 2008; 9: 132–139.