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Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()

BACKGROUND: Increasing bodies of evidence suggest that metformin may be beneficial in the primary prevention of colorectal cancer (CRC), and a dose–response relationship has been reported. However, long-term epidemiological observations between the treatment period, cumulative dose, and intensity of...

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Autores principales: Chang, Yu-Tang, Tsai, Hsiang-Lin, Kung, Ya-Ting, Yeh, Yung-Sung, Huang, Ching-Wen, Ma, Cheng-Jen, Chiu, Herng-Chia, Wang, Jaw-Yuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Neoplasia Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884217/
https://www.ncbi.nlm.nih.gov/pubmed/29524831
http://dx.doi.org/10.1016/j.tranon.2018.02.012
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author Chang, Yu-Tang
Tsai, Hsiang-Lin
Kung, Ya-Ting
Yeh, Yung-Sung
Huang, Ching-Wen
Ma, Cheng-Jen
Chiu, Herng-Chia
Wang, Jaw-Yuan
author_facet Chang, Yu-Tang
Tsai, Hsiang-Lin
Kung, Ya-Ting
Yeh, Yung-Sung
Huang, Ching-Wen
Ma, Cheng-Jen
Chiu, Herng-Chia
Wang, Jaw-Yuan
author_sort Chang, Yu-Tang
collection PubMed
description BACKGROUND: Increasing bodies of evidence suggest that metformin may be beneficial in the primary prevention of colorectal cancer (CRC), and a dose–response relationship has been reported. However, long-term epidemiological observations between the treatment period, cumulative dose, and intensity of metformin and CRC are rarely reported. The aim of this study was to identify the association between the effect of metformin and CRC development in a nationwide cohort study. METHODS: This nationwide population-based study examined a cohort of 1,000,000 patients randomly sampled from individuals enrolled in the Taiwan National Health Insurance system. Patients with newly diagnosed type 2 diabetes mellitus (DM) between 1997 and 2007 were enrolled. A statistical variables, including the demographic data, treatment period, cumulative dose, and intensity of metformin use, was compared between patients developing CRC and those without CRC. RESULTS: This study included 47,597 patients. The mean follow-time was 7.17 ± 3.21 years. After adjustment, metformin use was an independent protective factor against CRC development (P < .001). Although the protective ability of metformin against CRC development was reduced during long-term therapy, the risk of CRC decreased progressively with a higher cumulative dose or higher intensity of metformin use (both P < .001). CONCLUSION: This study revealed that metformin use significantly reduced the risk of CRC in a dose-dependent manner in patients with type 2 DM in the Taiwanese population. However, a gradual decline in medication adherence may reduce the protective ability of metformin against CRC development during long-term therapy.
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spelling pubmed-58842172018-04-06 Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()() Chang, Yu-Tang Tsai, Hsiang-Lin Kung, Ya-Ting Yeh, Yung-Sung Huang, Ching-Wen Ma, Cheng-Jen Chiu, Herng-Chia Wang, Jaw-Yuan Transl Oncol Original article BACKGROUND: Increasing bodies of evidence suggest that metformin may be beneficial in the primary prevention of colorectal cancer (CRC), and a dose–response relationship has been reported. However, long-term epidemiological observations between the treatment period, cumulative dose, and intensity of metformin and CRC are rarely reported. The aim of this study was to identify the association between the effect of metformin and CRC development in a nationwide cohort study. METHODS: This nationwide population-based study examined a cohort of 1,000,000 patients randomly sampled from individuals enrolled in the Taiwan National Health Insurance system. Patients with newly diagnosed type 2 diabetes mellitus (DM) between 1997 and 2007 were enrolled. A statistical variables, including the demographic data, treatment period, cumulative dose, and intensity of metformin use, was compared between patients developing CRC and those without CRC. RESULTS: This study included 47,597 patients. The mean follow-time was 7.17 ± 3.21 years. After adjustment, metformin use was an independent protective factor against CRC development (P < .001). Although the protective ability of metformin against CRC development was reduced during long-term therapy, the risk of CRC decreased progressively with a higher cumulative dose or higher intensity of metformin use (both P < .001). CONCLUSION: This study revealed that metformin use significantly reduced the risk of CRC in a dose-dependent manner in patients with type 2 DM in the Taiwanese population. However, a gradual decline in medication adherence may reduce the protective ability of metformin against CRC development during long-term therapy. Neoplasia Press 2018-03-07 /pmc/articles/PMC5884217/ /pubmed/29524831 http://dx.doi.org/10.1016/j.tranon.2018.02.012 Text en © 2017 Published by Elsevier Inc. on behalf of Neoplasia Press, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original article
Chang, Yu-Tang
Tsai, Hsiang-Lin
Kung, Ya-Ting
Yeh, Yung-Sung
Huang, Ching-Wen
Ma, Cheng-Jen
Chiu, Herng-Chia
Wang, Jaw-Yuan
Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title_full Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title_fullStr Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title_full_unstemmed Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title_short Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study()()()
title_sort dose-dependent relationship between metformin and colorectal cancer occurrence among patients with type 2 diabetes—a nationwide cohort study()()()
topic Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5884217/
https://www.ncbi.nlm.nih.gov/pubmed/29524831
http://dx.doi.org/10.1016/j.tranon.2018.02.012
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