Metformin use in cancer survivors with diabetes reduces all-cause mortality, based on the Korean National Health Insurance Service between 2002 and 2015
| Autor: | Yoon-Jong Bae, Eun-A Choi, Hyo-Sun You, Joungyoun Kim, Ye-Seul Kim, Hee-Taik Kang, Yonghwan Kim, Ye-Eun Han, Hyeong-Seop Kim, Jae-Woo Lee |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty endocrine system diseases National Health Programs Observational Study Kaplan-Meier Estimate malignant neoplasm non-insulin treated type 2 diabetes 03 medical and health sciences 0302 clinical medicine Cancer Survivors Internal medicine Diabetes mellitus Cause of Death Neoplasms Republic of Korea Diabetes Mellitus Medicine Humans Hypoglycemic Agents 030212 general & internal medicine Cause of death Aged Proportional Hazards Models Retrospective Studies business.industry Proportional hazards model Mortality rate Hazard ratio Cancer General Medicine Middle Aged medicine.disease mortality Metformin cancer survivorship Treatment Outcome 030220 oncology & carcinogenesis Cohort Female business medicine.drug Follow-Up Studies Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 |
| Popis: | Malignant neoplasms are the leading cause of death in Korea. We aimed to examine if metformin use in cancer survivors reduces all-cause mortality. This study was retrospectively designed based on data from the Korean National Health Insurance Service-National Health Screening Cohort (HEALS) between 2002 and 2015. The Kaplan–Meier estimator and log-rank test was performed to estimate the survival function according to metformin usage (3721 metformin non-users with diabetes, 5580 metformin users with diabetes, and 24,483 non-diabetic individuals). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were calculated using Cox proportional hazards regression models. The median follow-up duration was 4.2 years. The HRs (95% CIs) for all-cause mortality of metformin users and the non-diabetic group were 0.762 (0.683–0.850) and 1.055 (0.966–1.152) in men and 0.805 (0.649–0.999), and 1.049 (0.873–1.260) in women, respectively, compared with metformin non-users among diabetic cancer survivors, in a fully adjusted model. After stratifying metformin users into pre- and post-diagnosis of cancers, adjusted HRs (95% CIs) of pre- and post-diagnosis metformin users for all-cause mortality were 0.948 (0.839–1.071) and 0.530 (0.452–0.621) in men and 1.163 (0.921–1.469) and 0.439 (0.323–0.596) in women, respectively. Metformin use in cancer survivors with diabetes reduced overall mortality rates. In particular, metformin use after cancer diagnosis, not before cancer diagnosis, was inversely associated with overall mortality. Active treatment with metformin for diabetic cancer survivors after cancer diagnosis can improve their survival rates. |
| Databáze: | OpenAIRE |
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