Long-term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment: A nationwide cohort study

Y. I. Kim, S. Y. Kim, Soo Jeong Cho, J. H. Park, I. J. Choi, Y. J. Lee, E. K. Lee, M. C. Kook, C. G. Kim, K. W. Ryu, Y. W. Kim

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Abstract

Background Metformin use has been associated with a decreased incidence and mortality of various cancers. Aim To evaluate the association between metformin use and gastric cancer. Methods We randomly selected 100 000 type 2 diabetic patients from the 2004 Korean National Health Insurance claim database, and assessed gastric cancer incidence among 39 989 patients (aged 30-97 years) who were regularly treated with anti-diabetic drugs and followed-up from 2004 to 2010. In total, 26 690 patients had used metformin out of 32 978 diabetics who had not regularly used insulin (insulin non-users), and 5855 patients had used metformin out of 7011 regular insulin users. Results Patients who used metformin showed a lower incidence of gastric cancer than those who did not use metformin, in insulin non-users (P = 0.047, log-rank test). However, in patients on regular insulin, there was no difference of gastric cancer incidence according to metformin use. In insulin non-users, the adjusted hazard ratio (AHR) for metformin use was 0.73 (95% confidential interval [CI], 0.53-1.01) with borderline statistical significance (P = 0.059). Duration of metformin use was associated with the reduction in gastric cancer risk (AHR, 0.88; 95% CI 0.81-0.96, P = 0.003), especially in patients who used metformin for more than 3 years (AHR, 0.57; 95% CI, 0.37-0.87; P = 0.009). Conclusion Metformin use >3 years in type 2 diabetics who do not use insulin is associated with a significantly reduced gastric cancer risk.

Original languageEnglish
Pages (from-to)854-863
Number of pages10
JournalAlimentary Pharmacology and Therapeutics
Volume39
Issue number8
DOIs
StatePublished - 1 Jan 2014

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Metformin
Stomach Neoplasms
Cohort Studies
Insulin
Therapeutics
Incidence
National Health Programs
Databases

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Kim, Y. I. ; Kim, S. Y. ; Cho, Soo Jeong ; Park, J. H. ; Choi, I. J. ; Lee, Y. J. ; Lee, E. K. ; Kook, M. C. ; Kim, C. G. ; Ryu, K. W. ; Kim, Y. W. / Long-term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment : A nationwide cohort study. In: Alimentary Pharmacology and Therapeutics. 2014 ; Vol. 39, No. 8. pp. 854-863.
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abstract = "Background Metformin use has been associated with a decreased incidence and mortality of various cancers. Aim To evaluate the association between metformin use and gastric cancer. Methods We randomly selected 100 000 type 2 diabetic patients from the 2004 Korean National Health Insurance claim database, and assessed gastric cancer incidence among 39 989 patients (aged 30-97 years) who were regularly treated with anti-diabetic drugs and followed-up from 2004 to 2010. In total, 26 690 patients had used metformin out of 32 978 diabetics who had not regularly used insulin (insulin non-users), and 5855 patients had used metformin out of 7011 regular insulin users. Results Patients who used metformin showed a lower incidence of gastric cancer than those who did not use metformin, in insulin non-users (P = 0.047, log-rank test). However, in patients on regular insulin, there was no difference of gastric cancer incidence according to metformin use. In insulin non-users, the adjusted hazard ratio (AHR) for metformin use was 0.73 (95{\%} confidential interval [CI], 0.53-1.01) with borderline statistical significance (P = 0.059). Duration of metformin use was associated with the reduction in gastric cancer risk (AHR, 0.88; 95{\%} CI 0.81-0.96, P = 0.003), especially in patients who used metformin for more than 3 years (AHR, 0.57; 95{\%} CI, 0.37-0.87; P = 0.009). Conclusion Metformin use >3 years in type 2 diabetics who do not use insulin is associated with a significantly reduced gastric cancer risk.",
author = "Kim, {Y. I.} and Kim, {S. Y.} and Cho, {Soo Jeong} and Park, {J. H.} and Choi, {I. J.} and Lee, {Y. J.} and Lee, {E. K.} and Kook, {M. C.} and Kim, {C. G.} and Ryu, {K. W.} and Kim, {Y. W.}",
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Long-term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment : A nationwide cohort study. / Kim, Y. I.; Kim, S. Y.; Cho, Soo Jeong; Park, J. H.; Choi, I. J.; Lee, Y. J.; Lee, E. K.; Kook, M. C.; Kim, C. G.; Ryu, K. W.; Kim, Y. W.

In: Alimentary Pharmacology and Therapeutics, Vol. 39, No. 8, 01.01.2014, p. 854-863.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment

T2 - A nationwide cohort study

AU - Kim, Y. I.

AU - Kim, S. Y.

AU - Cho, Soo Jeong

AU - Park, J. H.

AU - Choi, I. J.

AU - Lee, Y. J.

AU - Lee, E. K.

AU - Kook, M. C.

AU - Kim, C. G.

AU - Ryu, K. W.

AU - Kim, Y. W.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background Metformin use has been associated with a decreased incidence and mortality of various cancers. Aim To evaluate the association between metformin use and gastric cancer. Methods We randomly selected 100 000 type 2 diabetic patients from the 2004 Korean National Health Insurance claim database, and assessed gastric cancer incidence among 39 989 patients (aged 30-97 years) who were regularly treated with anti-diabetic drugs and followed-up from 2004 to 2010. In total, 26 690 patients had used metformin out of 32 978 diabetics who had not regularly used insulin (insulin non-users), and 5855 patients had used metformin out of 7011 regular insulin users. Results Patients who used metformin showed a lower incidence of gastric cancer than those who did not use metformin, in insulin non-users (P = 0.047, log-rank test). However, in patients on regular insulin, there was no difference of gastric cancer incidence according to metformin use. In insulin non-users, the adjusted hazard ratio (AHR) for metformin use was 0.73 (95% confidential interval [CI], 0.53-1.01) with borderline statistical significance (P = 0.059). Duration of metformin use was associated with the reduction in gastric cancer risk (AHR, 0.88; 95% CI 0.81-0.96, P = 0.003), especially in patients who used metformin for more than 3 years (AHR, 0.57; 95% CI, 0.37-0.87; P = 0.009). Conclusion Metformin use >3 years in type 2 diabetics who do not use insulin is associated with a significantly reduced gastric cancer risk.

AB - Background Metformin use has been associated with a decreased incidence and mortality of various cancers. Aim To evaluate the association between metformin use and gastric cancer. Methods We randomly selected 100 000 type 2 diabetic patients from the 2004 Korean National Health Insurance claim database, and assessed gastric cancer incidence among 39 989 patients (aged 30-97 years) who were regularly treated with anti-diabetic drugs and followed-up from 2004 to 2010. In total, 26 690 patients had used metformin out of 32 978 diabetics who had not regularly used insulin (insulin non-users), and 5855 patients had used metformin out of 7011 regular insulin users. Results Patients who used metformin showed a lower incidence of gastric cancer than those who did not use metformin, in insulin non-users (P = 0.047, log-rank test). However, in patients on regular insulin, there was no difference of gastric cancer incidence according to metformin use. In insulin non-users, the adjusted hazard ratio (AHR) for metformin use was 0.73 (95% confidential interval [CI], 0.53-1.01) with borderline statistical significance (P = 0.059). Duration of metformin use was associated with the reduction in gastric cancer risk (AHR, 0.88; 95% CI 0.81-0.96, P = 0.003), especially in patients who used metformin for more than 3 years (AHR, 0.57; 95% CI, 0.37-0.87; P = 0.009). Conclusion Metformin use >3 years in type 2 diabetics who do not use insulin is associated with a significantly reduced gastric cancer risk.

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DO - 10.1111/apt.12660

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