Format

Send to

Choose Destination
Medicine (Baltimore). 2019 Oct;98(40):e17461. doi: 10.1097/MD.0000000000017461.

Does long-term use of antidiabetic drugs changes cancer risk?

Liu YC1, Nguyen PA2, Humayun A3, Chien SC2,4, Yang HC2,4, Asdary RN5, Syed-Abdul S2,4, Hsu MH6,7, Moldovan M8, Yen Y2,9,10, Li YJ2,4,7,11, Jian WS12,13, Iqbal U3,4,14.

Author information

1
Division of Nephrology, Department of Internal Medicine, Yuan's General Hospital, Kaohsiung City.
2
Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
3
Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Medical Complex, Lahore, Pakistan.
4
International Center for Health Information Technology (ICHIT).
5
Masters Program in Global Health & Department, College of Public Health, Taipei Medical University, Taipei.
6
Graduate Institute of Data Science.
7
Research Center of Artificial Intelligence in Medicine and Health (TAIMH), Taipei Medical University, Taipei, Taiwan.
8
South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
9
Ph.D Program for Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University.
10
Taipei Medical University Research Center of Cancer Translational Medicine.
11
Department of Dermatology, Wan Fang Hospital.
12
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
13
Faculty of Health Sciences, Macau University of Science and Technology, Macau.
14
Masters Program in Global Health & Development Department, PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.

Abstract

Antidiabetic medications are commonly used around the world, but their safety is still unclear. The aim of this study was to investigate whether long-term use of insulin and oral antidiabetic medications is associated with cancer risk.We conducted a well-designed case-control study using 12 years of data from Taiwan's National Health Insurance Research Database and investigated the association between antidiabetic medication use and cancer risk over 20 years. We identified 42,500 patients diagnosed with cancer and calculated each patient's exposure to antidiabetic drugs during the study period. We matched cancer and noncancer subjects matched 1:6 by age, gender, and index date, and used Cox proportional hazard regression and conditional logistic regression, adjusted for potential confounding factors, that is, medications and comorbid diseases that could influence cancer risk during study period.Pioglitazone (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.05-1.38); and insulin and its analogs for injection, intermediate or long acting combined with fast acting (AOR, 1.22; 95% CI, 1.05-1.43) were significantly associated with a higher cancer risk. However, metformin (AOR, 1.00; 95% CI, 0.93-1.07), glibenclamide (AOR, 0.98; 95% CI, 0.92-1.05), acarbose (AOR, 1.06; 95% CI, 0.96-1.16), and others do not show evidence of association with cancer risk. Moreover, the risk for specific cancers among antidiabetic users as compared with nonantidiabetic medication users was significantly increased for pancreas cancer (by 45%), liver cancer (by 32%), and lung cancer (by 18%).Antidiabetic drugs do not seem to be associated with an increased cancer risk incidence except for pioglitazone, insulin and its analogs for injection, intermediate or long acting combined with fast acting.

PMID:
31577776
PMCID:
PMC6783244
DOI:
10.1097/MD.0000000000017461
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wolters Kluwer Icon for PubMed Central
Loading ...
Support Center