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Metformin use lowered risk for cancer mortality
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New data indicate a lower cancer mortality risk for metformin users compared with non-users.
Researchers assessed data from 1,353 patients with type 2 diabetes in the Netherlands who participated in the ZODIAC-16 study in 1998 and 1999. To study the incidence of cancer mortality, the researchers calculated standardized mortality ratios for total, cardiovascular and cancer mortality. At baseline, the average age of patients was 68 years and average HbA1c was 7.5%.
During 9.6 years of follow-up, 570 (42%) patients died; 122 deaths were determined to be cancer-related (26 lung cancer; 21 abdominal cancer) and 238 cardiovascular disease-related.
Researchers reported that the standardized mortality ratio was 1.47 for cancer mortality (95% CI, 1.22-1.76), 2.45 for cardiovascular mortality (95% CI, 2.15-2.79) and 2.22 for overall mortality (95% CI, 2.03-2.42).
The standardized mortality ratio for cancer mortality in the metformin group was 0.88 (95% CI, 0.51-1.44) compared with 1.62 in the nonmetformin group (95% CI, 1.32-1.96).
For patients taking metformin vs. those not taking metformin at baseline, the HR for cancer mortality was 0.43 (95% CI, 0.23-0.80). For every 1-g increase in metformin dose, the risk for cancer mortality decreased by 42% (HR=0.58; 95% CI, 0.36-0.93).
The researchers concluded that “metformin use at baseline was associated with less cancer-related mortality and that this association appeared to be dose-dependent.”
The mortality ratio for patients taking metformin was comparable with that of the general population, according to the researchers.
“In our opinion, this finding further strengthens the position of metformin as the treatment of first choice in patient with type 2 diabetes,” they wrote. However, the current data do not provide a conclusion about causality.
For more information:
- Landman GWD. Diabetes Care. 2010;33:322-326.