Cancer risk in patients aged 30 years and above with type 2 diabetes receiving antidiabetic monotherapy: A cohort study using metformin as the comparator

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Title:	Cancer risk in patients aged 30 years and above with type 2 diabetes receiving antidiabetic monotherapy: A cohort study using metformin as the comparator
Authors:	洪炯宗;Kok, Victor;Chen, Yu-Ching;Chien, Ching-Hsuan;Horng, Jorng-Tzong;Tsai, Jeffrey
Contributors:	資訊電機學院資訊工程學系
Keywords:	Ambulatory care;antidiabetic drug;Antidiabetics;cancer risk;Cancer therapies;Carcinogenesis;Clinical medicine;Cohort analysis;Colorectal cancer;Diabetes;Drug therapy;Expenditures;Glucose;Health insurance;Health risk assessment;Kinases;Lung cancer;Metformin;monotherapy;NHIRD;Original Research;Patient outcomes;Risk factors;sulfonylureas;Systematic review;Type 2 diabetes
Date:	2015-08-28
Issue Date:	2026-04-23 13:22:49 (UTC+8)
Publisher:	Dove Medical Press Ltd.;New Zealand: Dove Medical Press Limited
Abstract:	摘要： Accumulating evidence suggests that metformin reduces incident cancer development. Few cohort studies have evaluated the risk of subsequent cancer development in diabetic cohorts receiving antidiabetic monotherapy. We conducted a population-based study in patients with new-onset type 2 diabetes treated with antidiabetic monotherapy. We identified a cohort of patients with type 2 diabetics aged ≥30 years receiving hypoglycemic monotherapy (n=7,325) from the 1998-2007 Longitudinal Health Insurance Dataset. Patients were grouped according to the antidiabetic therapy they received into metformin (n=2,223), sulfonylurea (n=3,965), glitazone (n=53), meglitinide (n=128), acarbose (n=150), and insulin (n=806) groups. Patients with preexisting cancer were excluded. All patients were followed up until cancer development, dropout, death, or until December 31, 2008. Cox's model was used to estimate multivariable hazard ratios (HRs) adjusted for age, sex, Charlson comorbidity index, smoking-related comorbidities, alcohol use disorders, morbid obesity, pancreatitis, hypertension, monthly income, and urbanization level. The log-rank test was used to compare cumulative cancer incidence. Two-sided P-values <0.05 were required to reject the null hypothesis. The overall median follow-up duration was 2.5 years (interquartile range, 3.6 years). Totally, 367 and 124 cancers developed in the sulfonylurea and metformin groups, respectively, representing an adjusted HR of 1.36 (95% confidence interval [CI], 1.11-1.67; P<0.005). No significant differences were observed between other groups. Increased adjusted HRs were observed for colorectal cancer (adjusted HR, 1.94; 95% CI, 1.15-3.27; P<0.05) and lung cancer (adjusted HR, 1.76; 95% CI, 1.00-3.07; P<0.05). Metformin monotherapy may be associated with a reduction in the risk for cancer development compared with sulfonylurea monotherapy. Moreover, the use of an average defined daily dose of >0.25 of metformin when compared to lower dose will contribute to a reduction of 80% risk. 其他題名： Ther Clin Risk Manag 出版者： New Zealand: Dove Medical Press Limited 出版日期： 2015-01-01 出處： Therapeutics and clinical risk management, 2015-01, Vol.11, p.1315-1323 資源來源： Healthcare Administration Database 版權： COPYRIGHT 2015 Dove Medical Press Limited 版權： 2015. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 版權： 2015 Chen et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License 2015 識別號： ISSN: 1178-203X 識別號： ISSN: 1176-6336 識別號： EISSN: 1178-203X 識別號： DOI: 10.2147/TCRM.S91513 識別號： PMID: 26357479
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