Diabetes mellitus and cancer of the digestive organs: An Italian population-based cohort study

Valent, Francesca

doi:10.1016/j.jdiacomp.2015.07.017

Cited by 52 publications

(73 citation statements)

References 21 publications

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“…The populations of the studies came from European countries (18,19) and Asian countries (10,20,21). Two included studies focused on GC, whereas the other three studies evaluated other general cancer types in addition to GC.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Therefore, this systematic review was conducted to elucidate this issue. Three studies (10,18,19) found that metformin reduced the risk of GC, whereas one study (21) showed that metformin could reduce the risk of other cancers, excluding GC. A recent clinical study (20) reported that metformin improved the survival of GC in diabetic patients subjected to gastrectomy by decreasing the recurrence, all-cause mortality, and cancer-specific mortality rates.…”

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

“…Two of the studies (18,19) included in this review evaluated another type of common hypoglycemic drug, sulfonylureas or sulfonylurea derivatives. Sulfonylureas are frequently prescribed with metformin for type 2 DM.…”

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

“…These authors found that the outcomes of patients treated with a combination of metformin and sulfonylureas were similar to those of patients treated with metformin alone. Notably, Valent (18) found that sulfonylureas had a unique protective association with the stomach and pancreas, and that sulfonylureas did not increase the incidence of any type of cancer.…”

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

“…Only five articles met the inclusion criteria of this study. The data of the four studies (10,18,19,21) included herein were obtained from national or local health databases or health insurance companies, from which critical data were not available, causing heterogeneity in the results.…”

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

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Metformin use and its effect on gastric cancer in patients with type 2 diabetes: A systematic review of observational studies

Zhang

Gao

et al. 2017

Oncol Lett

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Abstract. Increasing evidence suggests that metformin use is associated with a decreased risk of cancer. The traditional therapies for gastric cancer (GC) are gastrectomy and chemoradiotherapy; however, these therapies may cause certain adverse effects, which affect a patient's quality of life, and the overall survival rate is low. At present, little is known about whether the use of metformin decreases the risk of GC in patients with type 2 diabetes. Therefore, in the present study, a systematic review was performed to analyze the effect of metformin on GC. A literature search was conducted in PubMed, EMBASE, and the Cochrane Library databases for articles published up to June 30th, 2016. The studies that evaluated GC patients treated with metformin and compared them with GC patients treated with other antidiabetic drugs were reviewed. Eligible studies were evaluated using the Newcastle-Ottawa Scale. Adjusted hazard ratio and 95% confidence intervals were determined to evaluate the effect of metformin on GC. From the 422 articles evaluated, 5 studies involving a total of 1,804,479 patients met the inclusion criteria and were qualitatively analyzed. The quality of all selected articles was classified as moderate. These studies reported that the long-term use of metformin was associated with a lower risk of GC compared with the lack of use of metformin or the use of other hypoglycemic drugs. In GC patients with diabetes who were subjected to gastrectomy, the cumulative use of metformin reduced the rates of disease recurrence and of all-cause and cancer-specific mortality. Despite the limited number of studies on this subject, currently available evidence indicates that metformin is associated with a decreased risk of GC and improves survival in patients with type 2 diabetes. However, more well-designed trials are required to elucidate this association.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

Section: Selection Comparability Outcome ----------------------------mentioning

confidence: 99%

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Metformin use and its effect on gastric cancer in patients with type 2 diabetes: A systematic review of observational studies

Zhang

Gao

et al. 2017

Oncol Lett

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Aspirin, metformin, and statin use on the risk of gastric cancer: A nationwide population‐based cohort study in Korea with systematic review and meta‐analysis

et al. 2021

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Background/Aims Although several chemopreventive drugs against gastric cancer have been proposed, their effects have not been fully evaluated. We examined the impacts of aspirin, metformin, and statin use on gastric cancer development in a population‐based cohort in Korea. Methods We analyzed the association between potential chemopreventive drugs—aspirin, metformin, and statin—and gastric cancer through the Observational Medical Outcomes Partnership Common Data Model‐based Korean nationwide cohort. Use of aspirin, metformin, and statin was defined by ≥365 days of prescriptions for each drug in the general population. To summarize the current evidence, we further performed a systematic review and meta‐analysis of the impact of aspirin, metformin, and statin on gastric cancer development. Results After propensity score matching, 31,839, 6764, and 10,251 subjects were observed for medians of 4.7, 4.2, and 4.2 years for aspirin, metformin, and statin analysis, respectively. Use of aspirin or statin was associated with lower risks of gastric cancer compared to their non‐use, respectively (hazard ratio [HR] [95% confidence interval [CI]]: aspirin, 0.72 [0.60–0.85], p < 0.01; statin, 0.67 [0.49–0.92], p = 0.01). However, no association was observed between metformin use and gastric cancer development (HR [95% CI]: 0.85 [0.59–1.23], p = 0.40). A subgroup of subjects with diabetes mellitus showed a lower risk of gastric cancer development with statin use. The meta‐analysis showed the highest effect size of gastric cancer development for statin, followed by aspirin and metformin. Conclusions Statin and aspirin use were associated with significantly reduced risks of gastric cancer development, while the use of metformin was not associated with the gastric cancer risk. The protective effect of statin against gastric cancer was also significant in patients with diabetes mellitus.

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Association Between Type 1 Diabetes Mellitus and Incident Gastrointestinal Cancer in Korean Population: A Nationwide Retrospective Cohort Study

Shin,

Kim,

et al. 2024

Diabetes Metabolism Res

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BackgroundThe age‐standardised incidence ratio of gastrointestinal cancers in type 1 diabetes (T1D) patients has been reported to be higher than that in the general population. After adjusting for shared risk factors, we aimed to explore the association between T1D and gastrointestinal cancer and examine how this relationship varies by age and sex.Materials and MethodsThis retrospective cohort study included 268,179 participants from the Korean National Health Insurance Service‐National Sample Cohort. The primary outcome is the incident of gastrointestinal cancers, based on diagnostic codes. Multivariate Cox regression analyses were performed to assess the association between T1D and gastrointestinal cancers.ResultsOf the 268,179 participants, 2681 had T1D at baseline and were followed for 12.98 (± 2.92) years. Compared with non‐T1D, T1D patients had a significantly increased risk of all gastrointestinal cancer (adjusted hazard ratio [aHR]: 1.403, 95% confidence interval [CI]: 1.253–1.573). T1D patients increased risks of oesophageal cancer (aHR: 1.864, 95% CI: 1.038–3.349), gastric cancer (aHR: 1.313, 95% CI: 1.066–1.616), colon cancer (aHR: 1.365, 95% CI: 1.110–1.678), liver cancer (aHR: 1.388, 95% CI: 1.115–1.727), and pancreatic cancer (aHR: 1.716, 95% CI: 1.182–2.492). The consistency of this association persisted among both male and female, with its strength increasing with older age.ConclusionsThe risk of gastrointestinal cancer was significantly increased in T1D patients. Older male T1D patients exhibit a higher risk, suggesting the need for targeted attention in their care.

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Diabetes mellitus and cancer of the digestive organs: An Italian population-based cohort study

Cited by 52 publications

References 21 publications

Metformin use and its effect on gastric cancer in patients with type 2 diabetes: A systematic review of observational studies

Metformin use and its effect on gastric cancer in patients with type 2 diabetes: A systematic review of observational studies

Aspirin, metformin, and statin use on the risk of gastric cancer: A nationwide population‐based cohort study in Korea with systematic review and meta‐analysis

Association Between Type 1 Diabetes Mellitus and Incident Gastrointestinal Cancer in Korean Population: A Nationwide Retrospective Cohort Study

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