University of Oulu

Erkinantti, S., Marttila, M., Sund, R., Arffman, M., Urpilainen, E., Puistola, U., Hautakoski, A., Karihtala, P., Läärä, E., & Jukkola, A. (2021). Association of Metformin, Other Antidiabetic Medications, and Statins With Incidence of Colon Cancer in Patients With Type 2 Diabetes. Clinical Colorectal Cancer, 20(2), e113–e119.

Association of metformin, other antidiabetic medications, and statins with incidence of colon cancer in patients with type 2 diabetes

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Author: Erkinantti, Sami1; Marttila, Mikko2; Sund, Reijo3,4;
Organizations: 1Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Orion Corporation, Espoo, Finland
3Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland
4Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
5Service System Research Unit, National Institute for Health and Welfare, Helsinki, Finland
6Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
7Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
8Department of Oncology and Radiotherapy, Tampere University Hospital, Tampere, Finland
9Cancer Centre Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link:
Language: English
Published: Elsevier, 2021
Publish Date: 2022-11-16


Background: Metformin and statins may have anticancer effects, with plausible cellular mechanisms. However, the association of these agents with the risk of colorectal cancer is unclear.

Patients and Methods: This was a retrospective cohort study on a large population (N = 316,317) of patients with type 2 diabetes. Data were obtained from the Diabetes in Finland database (FinDM). In a full cohort analysis, hazard ratios (HRs) with their 95% confidence intervals (CIs) for ever use versus never use were estimated using a multiple Poisson regression model. A nested case–control design within the cohort was used to examine the association of colon cancer (CC) with the defined daily dose of medication. The data were analyzed by conditional logistic regression. The analyses were adjusted for the patient’s age, sex, and duration of diabetes.

Results: In total, 1351 CC cases were diagnosed during 1996–2011. The results revealed insufficient evidence for an association between metformin (HR, 1.01; 95% CI, 0.90–1.14), other oral antidiabetic medications (HR, 1.05; 95% CI, 0.93–1.19), insulin (HR, 1.02; 95% CI, 0.86–1.22), or statins (HR, 0.94; 95% CI, 0.84–1.05) and the incidence of CC in the full cohort analysis. The results from the case–control study were similar, with no consistent trend in the incidence of CC according to the cumulative dose of metformin or the other studied medications.

Conclusion: This study found insufficient evidence for an association between metformin, insulin, other oral type 2 diabetes medications, or statins and the incidence of CC.

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Series: Clinical colorectal cancer
ISSN: 1533-0028
ISSN-E: 1938-0674
ISSN-L: 1533-0028
Volume: 20
Issue: 2
Pages: e113 - e119
DOI: 10.1016/j.clcc.2020.11.003
Type of Publication: A1 Journal article – refereed
Field of Science: 112 Statistics and probability
3122 Cancers
Funding: Funded by grants from the Jane and Aatos Erkko Foundation, the Cancer Society of Finland, and Finnish government research funds granted to the University Hospital of Oulu.
Copyright information: © 2020 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license