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Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.

Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and...

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Autores principales: Orchard, Suzanne, Broder, Jonathan, Lockery, Jessica, Gibbs, Peter, Espinoza, Sara, Ernst, Michael, Woods, Robyn, McNeil, and John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8681499/
http://dx.doi.org/10.1093/geroni/igab046.2339
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author Orchard, Suzanne
Broder, Jonathan
Lockery, Jessica
Gibbs, Peter
Espinoza, Sara
Ernst, Michael
Woods, Robyn
McNeil, and John
author_facet Orchard, Suzanne
Broder, Jonathan
Lockery, Jessica
Gibbs, Peter
Espinoza, Sara
Ernst, Michael
Woods, Robyn
McNeil, and John
author_sort Orchard, Suzanne
collection PubMed
description Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk.
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spelling pubmed-86814992021-12-17 Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults. Orchard, Suzanne Broder, Jonathan Lockery, Jessica Gibbs, Peter Espinoza, Sara Ernst, Michael Woods, Robyn McNeil, and John Innov Aging Abstracts Diabetes increases risk of malignancies, and this association increases with age. Metformin may protect against cancer development and progression, but results are mixed and limited to younger cohorts. We examined whether metformin, in the presence or absence of aspirin, reduces incident cancer and cancer-related mortality in older adults. ASPirin in Reducing Events in the Elderly (ASPREE) was a primary prevention trial of daily aspirin vs placebo which enrolled community-dwelling adults from Australia (70+ years) and the US (65+ years for minorities) followed for a median of 4.7 years. Invasive cancer was adjudicated by an expert panel. Cox proportional-hazards models, controlling for age at randomization and known cancer risk factors, were used to analyse the relationship between baseline metformin use, randomized treatment arm, cancer incidence (first in-trial cancer) and mortality. For participants with controlled diabetes, there was a significant reduction in cancer mortality in metformin users compared to nonusers (Adjusted [Adj] HR=0.24, 95%CI=0.07, 0.80), but not for cancer incidence (Adj HR=0.61, 95%CI=0.29, 1.27). For participants with uncontrolled diabetes, there was no significant difference in cancer incidence (Adj HR=0.95, 95%CI=0.66, 1.38) or mortality (Adj HR=1.18, 95%CI=0.62, 2.26) between metformin and non-metformin users. Uncontrolled diabetes, irrespective of metformin use, increased risk of cancer incidence and mortality compared to non-diabetics. Aspirin did not modify the effect of metformin on cancer incidence or mortality. Our findings show that metformin may have protective effects against cancer-related mortality for those older persons whose diabetes is well-controlled, and underscores the importance of diabetes control to minimise cancer risk. Oxford University Press 2021-12-17 /pmc/articles/PMC8681499/ http://dx.doi.org/10.1093/geroni/igab046.2339 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Orchard, Suzanne
Broder, Jonathan
Lockery, Jessica
Gibbs, Peter
Espinoza, Sara
Ernst, Michael
Woods, Robyn
McNeil, and John
Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title_full Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title_fullStr Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title_full_unstemmed Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title_short Associations between Metformin and Aspirin Use on Cancer Incidence and Mortality in Older Adults.
title_sort associations between metformin and aspirin use on cancer incidence and mortality in older adults.
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8681499/
http://dx.doi.org/10.1093/geroni/igab046.2339
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