University of Oulu

Arima, Reetta & Marttila, Mikko & Hautakoski, Ari & Arffman, Martti & Sund, Reijo & Ilanne-Parikka, Pirjo & Kangaskokko, Jenni & Urpilainen, Elina & Läärä, Esa & Hinkula, Marianne & Puistola, Ulla; Antidiabetic Medication, Statins and the Risk and Prognosis of Non-endometrioid Endometrial Cancer in Women with Type 2 Diabetes. Anticancer Research, 38 (7), 4169-4178. doi:10.21873/anticanres.12710

Antidiabetic medication, statins and the risk and prognosis of non-endometrioid endometrial cancer in women with type 2 diabetes

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Author: Arima, Reetta1; 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, Oulu, Finland
2Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
3Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
4Service System Research Unit, National Institute for Health and Welfare, Helsinki, Finland
5Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland
6Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
7The Diabetes Center, Finnish Diabetes Association, Tampere, Finland
8Department of Pathology, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
9Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019052817613
Language: English
Published: International Institute of Anticancer Research, 2018
Publish Date: 2019-05-28
Description:

Abstract

Aim: To determine the incidence and prognosis of non-endometrioid endometrial cancer (EC) in relation to the use of metformin, other antidiabetic medication (ADM) and statins in patients with type 2 diabetes (T2D).

Materials and Methods: In order to analyze the incidence and prognosis of non-endometrioid EC, two cohorts were obtained from a nationwide diabetes database (FinDM); 57 non-endometrioid ECs were observed in a cohort of 92,366 women with newly-diagnosed T2D during the follow-up (1996 to 2011) to assess the incidence, and a retrospective cohort of 105 women with T2D diagnosed with non-endometrioid EC (1998 to 2011) was used to estimate cumulative mortality from EC and other causes of death. Hazard ratios (HRs) with 95% confidence intervals (CIs) for EC incidence were estimated in the full-cohort analysis and in the nested case–control analysis, matched for age and duration of T2D. Cumulative mortality was estimated by using the Aalen–Johansen estimator. Cause-specific mortality rates were analyzed by using Cox models regarding the pre-diagnostic use of different forms of ADM and statins.

Results: In the nested case–control analysis, the use of metformin was not associated with the risk of non-endometrioid EC (HR=1.09, 95% CI=0.59-2.00), whereas statin use was associated with a lower risk (HR=0.47, 95% CI=0.26-0.84). The results from the full-cohort analysis supported these findings. Mortality from non-endometrioid EC was not different between users of metformin and other types of oral ADM (HR=1.56, 95% CI=0.40-6.07) but was observed to be lower in statin users (HR=0.41, 95% CI=0.20-0.82).

Conclusions: Our findings were inconclusive regarding the association of metformin with the risk and prognosis of non-endometrioid EC. However, statin use was associated with a lower incidence and mortality from this disease.

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Series: Anticancer research
ISSN: 0250-7005
ISSN-E: 1791-7530
ISSN-L: 0250-7005
Volume: 38
Issue: 7
Pages: 4169 - 4178
DOI: 10.21873/anticanres.12710
OADOI: https://oadoi.org/10.21873/anticanres.12710
Type of Publication: A1 Journal article – refereed
Field of Science: 112 Statistics and probability
3122 Cancers
3123 Gynaecology and paediatrics
Subjects:
Funding: This work was supported by grants from the Jane and Aatos Erkko Foundation (grant number T59127), the Finnish Cancer Foundation (grant number T59129) and Finnish Government Research Funds allocated to the University Hospital of Oulu (grant number K77729).
Copyright information: © 2018, International Institute of Anticancer Research, All rights reserved. Published in this repository with the kind permission of the publisher.