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. 2021 Feb;36(2):303-310.
doi: 10.1007/s00384-020-03765-x. Epub 2020 Sep 23.

Metformin usage and the risk of colorectal cancer: a national cohort study

Jae-Woo Lee #  1 , Eun-A Choi #  2 , Ye-Seul Kim  1 , Yonghwan Kim  1 , Hyo-Sun You  1 , Ye-Eun Han  2 , Hyeong-Seop Kim  2 , Yoon-Jong Bae  2 , Joungyoun Kim #  3 , Hee-Taik Kang #  4   5
Affiliations

Metformin usage and the risk of colorectal cancer: a national cohort study

Jae-Woo Lee et al. Int J Colorectal Dis. 2021 Feb.

Abstract

Purpose: This study aimed to investigate the association between metformin usage and the risk of colorectal cancer (CRC) using data from the Korean National Health Insurance Service-National Health Screening Cohort database.

Methods: Data from the NHIS-HEALS cohort between 2002 and 2015 were longitudinally analyzed. Subjects were divided into three groups: metformin non-users with diabetes mellitus (DM), metformin users with DM, and no DM group. CRC was defined using the ICD-10 code (C18.0-C20.0) at the time of admission. Cox proportional hazard regression models were adopted after stepwise adjustment for confounders to investigate the association between metformin usage and colorectal cancer risk.

Results: During the follow-up period, of the total 323,430 participants, 2341 (1.33%) of the 175,495 males and 1204 (0.81%) of the 147,935 females were newly diagnosed with CRC. The estimated cumulative incidence of CRC was significantly different among the three groups based on Kaplan-Meier's survival curve (p values < 0.05 in both sexes). Compared with metformin non-users, hazard ratios (95% CIs) of metformin users and the no DM group were 0.66 (0.51-0.85) and 0.72 (0.61-0.85) in males and 0.59 (0.37-0.92) and 0.93 (0.66-1.29) in females, respectively, after being fully adjusted.

Conclusions: Metformin users with diabetes appear to have a significantly lower risk of CRC compared with metformin non-users.

Keywords: Colorectal cancer; Cox proportional hazard models; Diabetes; Kaplan-Meier estimate; Metformin.

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