Do antidiabetic medications influence colorectal cancer risk?

  • Shin CM & al.
  • Cancer Epidemiol
  • 27 Dec 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • The risk for colorectal cancer (CRC) was higher with sulphonylureas (except gliclazide) in patients with type 2 diabetes mellitus (T2DM).
  • Long-term follow-up studies are warranted for information on the association between newer antidiabetic medications and CRC risk.

Why this matters

  • There is no clarity whether CRC risk among patients with T2DM originates from hyperglycaemia itself or antidiabetic medications or both.

Study design

  • Population-based, nested case-control study on a prospective cohort provided by the National Health Insurance Corporation (2007-2014) was performed.
  • The study identified patients with newly diagnosed T2DM with (cases, n=4228) or without CRC (matched controls, n=4228).
  • Funding: the Korea government.

Key results

  • An increasing trend for CRC risk with increasing cumulative doses of sulphonylurea was noted (aOR, 1.14; 95% CI, 1.05-1.25; Pfor trend=.0008).
  • The risk for CRC increased in patients ≥65 years (aOR, 1.23; 95% CI, 1.06-1.42) but not in patients
  • The risk for CRC among patients using sulphonylurea drugs:
    • decreased with gliclazide (aOR, 0.85; 95% CI, 0.72-1.00; P<.0550>
    • increased with glimepiride (aOR, 1.14; 95% CI, 1.06-1.22); and
  • Metformin, dipeptidyl peptidase-4 inhibitors), thiazolidinediones, meglitide, and α-glucosidase inhibitor did not modify the risk for CRC.

Limitations

  • Data on glycated haemoglobin not captured.
  • Single measurement of glucose (fasting plasma glucose) was used to compare data.