University of Oulu

Reetta Arima, Mikko Marttila, Ari Hautakoski, Martti Arffman, Reijo Sund, Pirjo Ilanne-Parikka, Jenni Kangaskokko, Esa Läärä, Ulla Puistola, Marianne Hinkula, Antidiabetic medication, statins and the risk of endometrioid endometrial cancer in patients with type 2 diabetes, Gynecologic Oncology, Volume 146, Issue 3, 2017, Pages 636-641, ISSN 0090-8258,

Antidiabetic medication, statins and the risk of endometrioid endometrial cancer in patients with type 2 diabetes

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Author: Arima, Reetta1; Marttila, Mikko2; Hautakoski, Ari2;
Organizations: 1Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029 Oulu, Finland
2Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, P.O. Box 310, FIN-90101 Oulu, Finland
3Service System Research Unit, National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland
4Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland
5Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FIN-70211 Kuopio, Finland
6Science Center, Tampere University Hospital, Tampere, Finland
7The Diabetes Center, Finnish Diabetes Association, FIN-33680 Tampere, Finland
8Department of Pathology, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 50, FIN-90029 Oulu, Finland
9Research Unit of Mathematical Sciences, University of Oulu, P.O. Box 8000, FIN-90014 Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Elsevier, 2017
Publish Date: 2019-05-22


Objective: To gain further evidence of an association between the incidence of endometrial cancer (EC) and the use of metformin, other antidiabetic medication (ADM) and statins in women with type 2 diabetes (T2D).

Methods: A retrospective cohort of 92,366 women with newly diagnosed T2D was obtained from a diabetes register (FinDM). 590 endometrioid ECs were observed during the follow-up time. Poisson regression was utilized to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of the endometrioid EC in relation to the use of metformin, other oral ADM, insulin and statins. Nested case-control analyses were performed, where up to 20 controls were matched for age and duration of DM for each EC case. The HRs were estimated by conditional logistic regression for never/ever and cumulative use of different forms of ADM and statins.

Results: In the case-control analyses the use of metformin (HR 1.24, 95% CI 1.02–1.51) and other oral ADM (HR 1.25, 95% CI 1.04–1.50) was associated with an increased incidence of endometrioid EC compared to no ADM use. No difference was observed between metformin users and those using other oral ADMs. The use of statins was inversely related to the incidence of endometrioid EC (HR 0.78, 95% CI 0.65–0.94). Results from the full cohort analysis supported this finding.

Conclusions: In our study the use of metformin or other oral forms of ADM was not associated with a lowered risk of endometrioid EC in women with T2D. Instead statins were observed to be inversely associated with endometrioid EC in this population.

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Series: Gynecologic oncology
ISSN: 0090-8258
ISSN-E: 1095-6859
ISSN-L: 0090-8258
Volume: 146
Pages: 636 - 641
DOI: 10.1016/j.ygyno.2017.06.011
Type of Publication: A1 Journal article – refereed
Field of Science: 112 Statistics and probability
3122 Cancers
3123 Gynaecology and paediatrics
Funding: Our study group has received grants from Jane and Aatos Erkko Foundation, The Finnish Cancer Foundation and The Government Research Funds admitted to the University Hospital of Oulu. These funders had no role in study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the paper for publication.
Copyright information: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license