University of Oulu

Urpilainen, E., Marttila, M., Hautakoski, A., Arffman, M., Sund, R., Ilanne-Parikka, P., Arima, R., Kangaskokko, J., Puistola, U., Hinkula, M., Läärä, E. (2018) Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins: a retrospective cohort study. BMC Cancer, 18 (1), . doi:10.1186/s12885-018-4676-z

Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins : a retrospective cohort study

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Author: Urpilainen, Elina1; Marttila, Mikko2; Hautakoski, Ari3;
Organizations: 1Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu
2Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare
3Research Unit of Mathematical Sciences, University of Oulu
4Service System Research Unit, National Institute for Health and Welfare
5Centre for Research Methods, Department of Social Research, University of Helsinki
6Institute of Clinical Medicine, University of Eastern Finland
7The Diabetes Center, Finnish Diabetes Association
8Medical Research Center Oulu, University of Oulu
9Coronaria Diagnostics Oy, Oulu laboratory
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: Springer Nature, 2018
Publish Date: 2018-09-27


Background: Ovarian cancer is one of the most lethal cancers and women with type 2 diabetes (T2D) have even poorer survival from it. We assessed the prognosis of ovarian cancer in women with type 2 diabetes treated with metformin, other forms of antidiabetic medication, or statins.

Methods: Study cohort consisted of women with T2D diagnosed with ovarian cancer in Finland 1998–2011. They were identified from a nationwide diabetes database (FinDM), being linked to several national registers. Patients were grouped according to their medication in the three years preceding ovarian cancer diagnosis. The Aalen–Johansen estimator was used to describe cumulative mortality from ovarian cancer and from other causes in different medication groups. Mortality rates were analysed by Cox models, and adjusted hazard ratios (HR) with 95% confidence intervals (95% CIs) were estimated in relation to the use of different forms of medication. Main outcome measures were death from ovarian cancer and death from other causes.

Results: During the accrual period 421 newly diagnosed ovarian cancers were identified in the FinDM database. No evidence was found for any differences in mortality from ovarian cancer or other causes between different antidiabetic medication groups. Pre-diagnostic use of statins was observed to be associated with decreased mortality from ovarian cancer compared with no such use (HR 0.72, 95% CI 0.56–0.93).

Conclusions: Our findings are inconclusive as regards the association between metformin and ovarian cancer survival. However, some evidence was found for improved prognosis of ovarian cancer with pre-diagnostic statin use, requiring cautious interpretation, though.

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Series: BMC cancer
ISSN: 1471-2407
ISSN-E: 1471-2407
ISSN-L: 1471-2407
Volume: 18
Article number: 767
DOI: 10.1186/s12885-018-4676-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3122 Cancers
112 Statistics and probability
Funding: This work was supported by Finnish Government Research Funds allocated to the University Hospital of Oulu and by grants from the Jane and Aatos Erkko Foundation and the Cancer Foundation of Finland.
Dataset Reference: Additional files:
Copyright information: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.