University of Oulu

Erkinantti S, Hautakoski A, Sund R, et al. The Association of Metformin, Other Antidiabetic Medications, and Statins With the Prognosis of Colon Cancer in Patients With Type 2 Diabetes: A Retrospective Cohort Study. Cancer Control. 2022;29. doi:10.1177/10732748221134090

The association of metformin, other antidiabetic medications, and statins with the prognosis of colon cancer in patients with type 2 diabetes : a retrospective cohort study

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Author: Erkinantti, Sami1; Hautakoski, Ari2; Sund, Reijo3;
Organizations: 1Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu,Finland
3Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
4Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
5Department of Oncology and Radiotherapy, Tampere University Hospital, Cancer Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
6Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
7Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
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Language: English
Published: SAGE Publications, 2022
Publish Date: 2023-06-16


Background: Use of metformin and statins have been associated with improved prognosis of colon cancer (CC) in patients with type 2 diabetes (T2D). We examined the survival from CC in relation to the use of metformin, other oral antidiabetic medications (ADM), insulin, and statins in T2D patients.

Materials and Methods: A cohort (n = 2252) of persons with pre-existing T2D diagnosed with incident CC between 1998 and 2011 was identified from several Finnish registers. Cox models were fitted for cause-specific mortality rates to obtain adjusted estimates of the hazard ratios (HR) with 95% confidence intervals (CI) in relation to use of ADM and statins before the CC diagnosis. Cox models were also fitted for mortality in relation to post-diagnostic use of the medications treating these as time-dependent exposures, and starting follow-up 1 year after the CC diagnosis.

Results: Pre- and post-diagnostic metformin use was weakly associated with the risk of CC-related death (HR 0.75; 95% CI 0.58–0.99, and HR 0.78; 95% CI 0.54–1.14, respectively) compared to the use of other oral ADMs. Pre- and post-diagnostic statin use predicted a reduced risk of CC-related death (HR 0.83; 95% CI 0.71– 0.98, and HR 0.69; 95% CI 0.54–0.89, respectively).

Conclusions: Additional evidence was found for use of statins being associated with an improved survival from CC in patients with pre-existing T2D, but for metformin use the evidence was weaker.

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Series: Cancer control
ISSN: 1073-2748
ISSN-E: 2057-2816
ISSN-L: 1073-2748
Volume: 29
DOI: 10.1177/10732748221134090
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Jane and Aatos Erkko Foundation (T59127); Finnish Government Research Funds (K77729) and personal funding from Orion Research Foundation sr.
Copyright information: © The Author(s) 2022. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative CommonsAttribution-NonCommercial 4.0 License ( which permits non-commercial use,reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (