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BMC Cancer. 2018 Jul 28;18(1):767. doi: 10.1186/s12885-018-4676-z.

Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins: a retrospective cohort study.

Author information

1
Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029, Oulu, Finland. elina.urpilainen@gmail.com.
2
Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, P.O. Box 310, FIN-90101, Oulu, Finland.
3
Research Unit of Mathematical Sciences, University of Oulu, P.O. Box 8000, FIN-90014, Oulu, Finland.
4
Service System Research Unit, National Institute for Health and Welfare, P.O. Box 30, FIN-00271, Helsinki, Finland.
5
Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland.
6
Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland.
7
The Diabetes Center, Finnish Diabetes Association, FIN-33680, Tampere, Finland.
8
Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, P.O. Box 23, FIN-90029, Oulu, Finland.
9
Medical Research Center Oulu, University of Oulu, P.O. Box 8000, FIN-90014, Oulu, Finland.
10
Coronaria Diagnostics Oy, Oulu laboratory, FIN-90100, Oulu, Finland.

Abstract

BACKGROUND:

Ovarian cancer is one of the most lethal cancers and women with type 2 diabetes (T2D) have even poorer survival from it. We assessed the prognosis of ovarian cancer in women with type 2 diabetes treated with metformin, other forms of antidiabetic medication, or statins.

METHODS:

Study cohort consisted of women with T2D diagnosed with ovarian cancer in Finland 1998-2011. They were identified from a nationwide diabetes database (FinDM), being linked to several national registers. Patients were grouped according to their medication in the three years preceding ovarian cancer diagnosis. The Aalen-Johansen estimator was used to describe cumulative mortality from ovarian cancer and from other causes in different medication groups. Mortality rates were analysed by Cox models, and adjusted hazard ratios (HR) with 95% confidence intervals (95% CIs) were estimated in relation to the use of different forms of medication. Main outcome measures were death from ovarian cancer and death from other causes.

RESULTS:

During the accrual period 421 newly diagnosed ovarian cancers were identified in the FinDM database. No evidence was found for any differences in mortality from ovarian cancer or other causes between different antidiabetic medication groups. Pre-diagnostic use of statins was observed to be associated with decreased mortality from ovarian cancer compared with no such use (HR 0.72, 95% CI 0.56-0.93).

CONCLUSIONS:

Our findings are inconclusive as regards the association between metformin and ovarian cancer survival. However, some evidence was found for improved prognosis of ovarian cancer with pre-diagnostic statin use, requiring cautious interpretation, though.

KEYWORDS:

Antidiabetic medication; Cancer prognosis; Cancer survival; Metformin; Ovarian cancer; Statins; Type 2 diabetes

PMID:
30055585
PMCID:
PMC6064082
DOI:
10.1186/s12885-018-4676-z
[Indexed for MEDLINE]
Free PMC Article

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