Anti-diabetic medications and the risk for colorectal cancer: A population-based nested case-control study

Cheol Min Shin, Nayoung Kim, Kyungdo Han, Bongseong Kim, Jin Hyung Jung, Tae Jung Oh, Dong Ho Lee

Research output: Contribution to journalArticle

Abstract

Background: To evaluate whether anti-diabetic medications are related to colorectal cancer (CRC) risk in type 2 diabetes patients. Methods: The study was performed from a population-based prospective cohort provided by the National Health Insurance Corporation (2007–2014). Among the 2,084,602 patients newly diagnosed as type 2 diabetes in this period, the cases had incident CRC identified at least 3 years after the diagnosis, and the controls were matched to each case by age, sex, body mass index (BMI), fasting plasma glucose level, and year of the diagnosis. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and its 95 % confidence intervals (CIs) for CRC by anti-diabetic medications. Results: A total of 4,228 cases were identified and 4,228 controls were matched to the cases. Sulfonylurea use increased the risk for CRC [aOR (95 % CI), 1.14 (1.05–1.25)], showing an increasing trend with increasing cumulative doses (p for trend = 0.0008). In subgroup analysis, sulfonylurea use increased the CRC risk in DM patients ≥ 65 years, but not in the patients < 65 years. Among sulfonylurea drugs, gliclazide decreased the CRC risk [0.85 (0.72–1.00), p < 0.05], whereas glimepiride increased the risk significantly [1.14 (1.06–1.22)]. In contrast, metformin, meglitide, thiazolidinedione, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitor use did not modify the CRC risk. Conclusions: Our results suggest that sulfonylureas except for gliclazide increase the CRC risk in type 2 diabetic patients. Long-term follow-up studies are necessary to clarify the association of newer anti-diabetic medications with the CRC incidence.

Original languageEnglish
Article number101658
JournalCancer Epidemiology
Volume64
DOIs
StatePublished - Feb 2020

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Case-Control Studies
Colorectal Neoplasms
Population
Gliclazide
glimepiride
Type 2 Diabetes Mellitus
Odds Ratio
Confidence Intervals
Dipeptidyl-Peptidase IV Inhibitors
Glucosidases
Metformin
National Health Programs
Fasting
Body Mass Index
Logistic Models
Glucose
Incidence
Pharmaceutical Preparations

Keywords

  • Anti-diabetic medications
  • Colorectal cancer
  • Diabetes
  • Gliclazide
  • Sulfonylurea

Cite this

Shin, Cheol Min ; Kim, Nayoung ; Han, Kyungdo ; Kim, Bongseong ; Jung, Jin Hyung ; Oh, Tae Jung ; Lee, Dong Ho. / Anti-diabetic medications and the risk for colorectal cancer : A population-based nested case-control study. In: Cancer Epidemiology. 2020 ; Vol. 64.
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abstract = "Background: To evaluate whether anti-diabetic medications are related to colorectal cancer (CRC) risk in type 2 diabetes patients. Methods: The study was performed from a population-based prospective cohort provided by the National Health Insurance Corporation (2007–2014). Among the 2,084,602 patients newly diagnosed as type 2 diabetes in this period, the cases had incident CRC identified at least 3 years after the diagnosis, and the controls were matched to each case by age, sex, body mass index (BMI), fasting plasma glucose level, and year of the diagnosis. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and its 95 {\%} confidence intervals (CIs) for CRC by anti-diabetic medications. Results: A total of 4,228 cases were identified and 4,228 controls were matched to the cases. Sulfonylurea use increased the risk for CRC [aOR (95 {\%} CI), 1.14 (1.05–1.25)], showing an increasing trend with increasing cumulative doses (p for trend = 0.0008). In subgroup analysis, sulfonylurea use increased the CRC risk in DM patients ≥ 65 years, but not in the patients < 65 years. Among sulfonylurea drugs, gliclazide decreased the CRC risk [0.85 (0.72–1.00), p < 0.05], whereas glimepiride increased the risk significantly [1.14 (1.06–1.22)]. In contrast, metformin, meglitide, thiazolidinedione, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitor use did not modify the CRC risk. Conclusions: Our results suggest that sulfonylureas except for gliclazide increase the CRC risk in type 2 diabetic patients. Long-term follow-up studies are necessary to clarify the association of newer anti-diabetic medications with the CRC incidence.",
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Anti-diabetic medications and the risk for colorectal cancer : A population-based nested case-control study. / Shin, Cheol Min; Kim, Nayoung; Han, Kyungdo; Kim, Bongseong; Jung, Jin Hyung; Oh, Tae Jung; Lee, Dong Ho.

In: Cancer Epidemiology, Vol. 64, 101658, 02.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Anti-diabetic medications and the risk for colorectal cancer

T2 - A population-based nested case-control study

AU - Shin, Cheol Min

AU - Kim, Nayoung

AU - Han, Kyungdo

AU - Kim, Bongseong

AU - Jung, Jin Hyung

AU - Oh, Tae Jung

AU - Lee, Dong Ho

PY - 2020/2

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N2 - Background: To evaluate whether anti-diabetic medications are related to colorectal cancer (CRC) risk in type 2 diabetes patients. Methods: The study was performed from a population-based prospective cohort provided by the National Health Insurance Corporation (2007–2014). Among the 2,084,602 patients newly diagnosed as type 2 diabetes in this period, the cases had incident CRC identified at least 3 years after the diagnosis, and the controls were matched to each case by age, sex, body mass index (BMI), fasting plasma glucose level, and year of the diagnosis. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and its 95 % confidence intervals (CIs) for CRC by anti-diabetic medications. Results: A total of 4,228 cases were identified and 4,228 controls were matched to the cases. Sulfonylurea use increased the risk for CRC [aOR (95 % CI), 1.14 (1.05–1.25)], showing an increasing trend with increasing cumulative doses (p for trend = 0.0008). In subgroup analysis, sulfonylurea use increased the CRC risk in DM patients ≥ 65 years, but not in the patients < 65 years. Among sulfonylurea drugs, gliclazide decreased the CRC risk [0.85 (0.72–1.00), p < 0.05], whereas glimepiride increased the risk significantly [1.14 (1.06–1.22)]. In contrast, metformin, meglitide, thiazolidinedione, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitor use did not modify the CRC risk. Conclusions: Our results suggest that sulfonylureas except for gliclazide increase the CRC risk in type 2 diabetic patients. Long-term follow-up studies are necessary to clarify the association of newer anti-diabetic medications with the CRC incidence.

AB - Background: To evaluate whether anti-diabetic medications are related to colorectal cancer (CRC) risk in type 2 diabetes patients. Methods: The study was performed from a population-based prospective cohort provided by the National Health Insurance Corporation (2007–2014). Among the 2,084,602 patients newly diagnosed as type 2 diabetes in this period, the cases had incident CRC identified at least 3 years after the diagnosis, and the controls were matched to each case by age, sex, body mass index (BMI), fasting plasma glucose level, and year of the diagnosis. Conditional logistic regression was used to calculate the adjusted odds ratio (aOR) and its 95 % confidence intervals (CIs) for CRC by anti-diabetic medications. Results: A total of 4,228 cases were identified and 4,228 controls were matched to the cases. Sulfonylurea use increased the risk for CRC [aOR (95 % CI), 1.14 (1.05–1.25)], showing an increasing trend with increasing cumulative doses (p for trend = 0.0008). In subgroup analysis, sulfonylurea use increased the CRC risk in DM patients ≥ 65 years, but not in the patients < 65 years. Among sulfonylurea drugs, gliclazide decreased the CRC risk [0.85 (0.72–1.00), p < 0.05], whereas glimepiride increased the risk significantly [1.14 (1.06–1.22)]. In contrast, metformin, meglitide, thiazolidinedione, dipeptidyl peptidase-4 inhibitors, and α-glucosidase inhibitor use did not modify the CRC risk. Conclusions: Our results suggest that sulfonylureas except for gliclazide increase the CRC risk in type 2 diabetic patients. Long-term follow-up studies are necessary to clarify the association of newer anti-diabetic medications with the CRC incidence.

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