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Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review

AIMS/HYPOTHESIS: Diabetes treatments were related with either an increased or reduced risk of cancer. There is ongoing debate about a potential protective action of metformin. To summarize evidence on the association between metformin and risk of cancer and cancer mortality in patients with diabetes...

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Autores principales: Franciosi, Monica, Lucisano, Giuseppe, Lapice, Emanuela, Strippoli, Giovanni F. M., Pellegrini, Fabio, Nicolucci, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732236/
https://www.ncbi.nlm.nih.gov/pubmed/23936520
http://dx.doi.org/10.1371/journal.pone.0071583
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author Franciosi, Monica
Lucisano, Giuseppe
Lapice, Emanuela
Strippoli, Giovanni F. M.
Pellegrini, Fabio
Nicolucci, Antonio
author_facet Franciosi, Monica
Lucisano, Giuseppe
Lapice, Emanuela
Strippoli, Giovanni F. M.
Pellegrini, Fabio
Nicolucci, Antonio
author_sort Franciosi, Monica
collection PubMed
description AIMS/HYPOTHESIS: Diabetes treatments were related with either an increased or reduced risk of cancer. There is ongoing debate about a potential protective action of metformin. To summarize evidence on the association between metformin and risk of cancer and cancer mortality in patients with diabetes. METHODS: Data source: MEDLINE and EMBASE (January 1966-April 2012). We selected randomized studies comparing metformin and other hypoglycaemic agents and observational studies exploring the association between exposure to metformin and cancer. Outcomes were cancer mortality, all malignancies and site-specific cancers. RESULTS: Of 25307 citations identified, 12 randomized controlled trials (21,595 patients) and 41 observational studies (1,029,389 patients) met the inclusion criteria. In observational studies there was a significant association of exposure to metformin with the risk of cancer death [6 studies, 24,410 patients, OR:0.65, 95%CI: 0.53-0.80], all malignancies [18 studies, 561,836 patients, OR:0.73, 95%CI: 0.61-0.88], liver [8 studies, 312,742 patients, OR:0.34; 95%CI: 0.19-0.60] colorectal [12 studies, 871,365 patients, OR:0.83, 95%CI: 0.74–0.92], pancreas [9 studies, 847,248 patients, OR:0.56, 95%CI: 0.36–0.86], stomach [2 studies, 100701 patients, OR:0.83, 95%CI: 0.76–0.91], and esophagus cancer [2 studies, 100694 patients, OR:0.90, 95%CI: 0.83–0.98]. No significant difference of risk was observed in randomized trials. Metformin was not associated with the risk of: breast cancer, lung cancer, ovarian cancer, uterus cancer, prostate cancer, bladder cancer, kidney cancer, and melanoma. CONCLUSIONS/INTERPRETATION: Results suggest that Metformin might be associated with a significant reduction in the risk of cancer and cancer-related mortality. Randomized trials specifically designed to evaluate the efficacy of metformin as an anticancer agent are warranted.
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spelling pubmed-37322362013-08-09 Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review Franciosi, Monica Lucisano, Giuseppe Lapice, Emanuela Strippoli, Giovanni F. M. Pellegrini, Fabio Nicolucci, Antonio PLoS One Research Article AIMS/HYPOTHESIS: Diabetes treatments were related with either an increased or reduced risk of cancer. There is ongoing debate about a potential protective action of metformin. To summarize evidence on the association between metformin and risk of cancer and cancer mortality in patients with diabetes. METHODS: Data source: MEDLINE and EMBASE (January 1966-April 2012). We selected randomized studies comparing metformin and other hypoglycaemic agents and observational studies exploring the association between exposure to metformin and cancer. Outcomes were cancer mortality, all malignancies and site-specific cancers. RESULTS: Of 25307 citations identified, 12 randomized controlled trials (21,595 patients) and 41 observational studies (1,029,389 patients) met the inclusion criteria. In observational studies there was a significant association of exposure to metformin with the risk of cancer death [6 studies, 24,410 patients, OR:0.65, 95%CI: 0.53-0.80], all malignancies [18 studies, 561,836 patients, OR:0.73, 95%CI: 0.61-0.88], liver [8 studies, 312,742 patients, OR:0.34; 95%CI: 0.19-0.60] colorectal [12 studies, 871,365 patients, OR:0.83, 95%CI: 0.74–0.92], pancreas [9 studies, 847,248 patients, OR:0.56, 95%CI: 0.36–0.86], stomach [2 studies, 100701 patients, OR:0.83, 95%CI: 0.76–0.91], and esophagus cancer [2 studies, 100694 patients, OR:0.90, 95%CI: 0.83–0.98]. No significant difference of risk was observed in randomized trials. Metformin was not associated with the risk of: breast cancer, lung cancer, ovarian cancer, uterus cancer, prostate cancer, bladder cancer, kidney cancer, and melanoma. CONCLUSIONS/INTERPRETATION: Results suggest that Metformin might be associated with a significant reduction in the risk of cancer and cancer-related mortality. Randomized trials specifically designed to evaluate the efficacy of metformin as an anticancer agent are warranted. Public Library of Science 2013-08-02 /pmc/articles/PMC3732236/ /pubmed/23936520 http://dx.doi.org/10.1371/journal.pone.0071583 Text en © 2013 Franciosi et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Franciosi, Monica
Lucisano, Giuseppe
Lapice, Emanuela
Strippoli, Giovanni F. M.
Pellegrini, Fabio
Nicolucci, Antonio
Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title_full Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title_fullStr Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title_full_unstemmed Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title_short Metformin Therapy and Risk of Cancer in Patients with Type 2 Diabetes: Systematic Review
title_sort metformin therapy and risk of cancer in patients with type 2 diabetes: systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732236/
https://www.ncbi.nlm.nih.gov/pubmed/23936520
http://dx.doi.org/10.1371/journal.pone.0071583
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