期刊
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
卷 23, 期 10, 页码 1974-1984出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-14-0327
关键词
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资金
- Canadian Breast Cancer Research Foundation
- Applied Research Chair Award from the Canadian Institute of Health Research
- Canadian Diabetes Association/Canadian Institutes of Health Research Clinician Scientist Award
- CIHR New Investigator Award
Diabetes may be a risk factor for cancer and is associated with worse cancer outcomes. Metformin may reduce cancer risk; however, its effect on mortality following cancer remains less clear. EMBASE and Medline were searched through February 10, 2014, for studies reporting an adjusted risk estimate for the effect of metformin therapy on mortality following cancer among diabetic patients. Random-effects models were used to obtain summary HR for the association between metformin and all-cause and cancer-specific mortality. Twenty-one observational studies were meta-analyzed in the primary analysis. Metformin was associated with a reduction in all-cause mortality [HR, 0.73; 95% confidence intervals (CI), 0.64-0.83] and cancer-specific mortality (HR, 0.74; 95% CI, 0.62-0.88). Subgroup analyses by cancer site showed a significant reduction in mortality for colon cancer (four studies, HR, 0.65; 95% CI, 0.56-0.76) but not for breast and prostate cancers. Observational studies indicate that metformin exposure at cancer diagnosis may be associated with a reduction in mortality. However, these findings need to be interpreted with caution as methodologic limitations of individual studies may have introduced biases in these findings. Our results emphasize the need for well-designed studies to further understand the relationship between metformin and survival following cancer. (C)2014 AACR.
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