Skip to main content

Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer.

Publication ,  Journal Article
Paulus, JK; Williams, CD; Cossor, FI; Kelley, MJ; Martell, RE
Published in: Cancer Epidemiol Biomarkers Prev
October 2016

BACKGROUND: Metformin has been associated with improved colorectal cancer survival, but investigations are limited by small numbers of patients and confounding by diabetic severity. We examined the association between metformin use and overall survival (OS) in patients with diabetes and colorectal cancer in a large population of U.S. veterans, while adjusting for measures of diabetic severity. METHODS: Patients diagnosed with colorectal cancer from January 2001 to December 2008 were identified from the Veterans Affairs Central Cancer Registry. Multivariable models were used to examine the adjusted association of OS with diabetes and use of antidiabetic medications. RESULTS: There were 21,352 patients diagnosed with colorectal cancer identified (n = 16,355 nondiabetic patients, n = 2,038 diabetic patients on metformin, n = 2,136 diabetic patients on medications other than metformin, n = 823 diabetic patients not on antidiabetic medication). Diabetic patients had a significantly worse OS than nondiabetic patients, but metformin users had only a 10% increase in death (HRadj 1.10; 95% CI, 1.03-1.17, P = 0.004), as compared with 22% for users of other antidiabetic medications (HRadj 1.22; 95% CI, 1.15-1.29, P < 0.0001). Among colorectal cancer patients with diabetes, metformin users had a 13% improved OS versus patients taking other antidiabetic medications (HRadj 0.87; 95% CI, 0.79-0.95, P = 0.003), while diabetic patients not on any antidiabetic medications did not differ with respect to OS (HRadj 1.02; 95% CI, 0.90-1.15, P = 0.76). CONCLUSIONS: Among diabetics with colorectal cancer, metformin use is associated with improved survival, despite adjustments for diabetes severity and other risk factors. IMPACT: These data lend further support to the conduct of randomized studies of possible anticancer effects of metformin among patients with colorectal cancer. Cancer Epidemiol Biomarkers Prev; 25(10); 1418-25. ©2016 AACR.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

October 2016

Volume

25

Issue

10

Start / End Page

1418 / 1425

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Metformin
  • Male
  • Kaplan-Meier Estimate
  • Hypoglycemic Agents
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Paulus, J. K., Williams, C. D., Cossor, F. I., Kelley, M. J., & Martell, R. E. (2016). Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer. Cancer Epidemiol Biomarkers Prev, 25(10), 1418–1425. https://doi.org/10.1158/1055-9965.EPI-16-0312
Paulus, Jessica K., Christina D. Williams, Furha I. Cossor, Michael J. Kelley, and Robert E. Martell. “Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer.Cancer Epidemiol Biomarkers Prev 25, no. 10 (October 2016): 1418–25. https://doi.org/10.1158/1055-9965.EPI-16-0312.
Paulus JK, Williams CD, Cossor FI, Kelley MJ, Martell RE. Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer. Cancer Epidemiol Biomarkers Prev. 2016 Oct;25(10):1418–25.
Paulus, Jessica K., et al. “Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer.Cancer Epidemiol Biomarkers Prev, vol. 25, no. 10, Oct. 2016, pp. 1418–25. Pubmed, doi:10.1158/1055-9965.EPI-16-0312.
Paulus JK, Williams CD, Cossor FI, Kelley MJ, Martell RE. Metformin, Diabetes, and Survival among U.S. Veterans with Colorectal Cancer. Cancer Epidemiol Biomarkers Prev. 2016 Oct;25(10):1418–1425.

Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

October 2016

Volume

25

Issue

10

Start / End Page

1418 / 1425

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Retrospective Studies
  • Proportional Hazards Models
  • Middle Aged
  • Metformin
  • Male
  • Kaplan-Meier Estimate
  • Hypoglycemic Agents
  • Humans