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Metformin and reduced risk of cancer in diabetic patients
Open accessAbstract
Voluntary surveillance systems are subject to under-reporting.Figures may underestimate true numbers.Miscategorisation of probable country of infection by presuming the country with the highest prevalence as the likely country of infection will underestimate the number of infections acquired in the United Kingdom, particularly among people originating from countries with high prevalence.New HIV diagnoses do not represent new HIV infections, as diagnosis can occur at any point between infection and death, which in the natural course of infection is typically 10-12 years.Furthermore, surveillance reports do not distinguish between partners infected in high prevalence countries while visiting and partners infected before migrating from those countries.The number of people becoming infected with HIV through heterosexual intercourse in the United Kingdom is rising steadily.As the number of heterosexuals living with HIV (diagnosed and undiagnosed) in the United Kingdom grows, the likelihood of heterosexual transmission within the country will increase, particularly among ethnic minorities.The continuing collaboration of those who contribute to the voluntary HIV/AIDS reporting system in England, Wales and Northern Ireland is gratefully acknowledged, as is the help, advice, and support of Kevin Fenton (Health Protection Agency (HPA)), Noel Gill (HPA), Phillip Mortimer (HPA), Linda Lazarus (Department of Health), and Daniel Thomas (Communicable Disease Surveillance Centre Wales), and administrative support provided by Fay Peyman (HPA) and Fateha Begum (HPA).Contributors: VLG followed up reports.SD analysed surveillance data and wrote the first draft.VLG, SD, KS, and BGE were involved in the drafting of subsequent versions.BGE is guarantor.Competing interests: None declared.Ethical approval: No patients' names are collected; instead surname Soundex codes are used and strict confidentiality of the
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“The reduced risk of cancer and cancer mortality observed in these studies has been consistently in the range of 25% to 30% [135-139,145-147].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [145]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Results of a growing number of observational human studies suggest that treatment with metformin (relative to other glucose-lowering therapies) is associated with reduced risk of cancer (89–93) or cancer mortality (94).”
From Diabetes and Cancer (2010) · cites this paper as [89]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“long-term use of metformin in type 2 diabetes patients has been linked to a decline in tumor incidence and a reduced rate of cancer-related deaths.192–196”
From Drug repurposing for cancer therapy (2024) · cites this paper as [196]
Experimental — accuracy not yet measuredIn the citing paper
“Furthermore, retrospective clinical studies have found that metformin use is associated with improved cancer outcomes, reductions in cancer incidence, and decreased cancer mortality (Evans et al., 2005; Franciosi et al., 2013; Gandini et al., 2014; Lee et al., 2012; Noto et al., 2012).”
From Targeting Metabolism for Cancer Therapy (2017) · cites this paper as Evans et al., 2005
In the citing paper
“A retrospective study published in 2005 reported that patients with diabetes who had been treated with metformin for T2DM had a lower risk of cancer and highlighted the possible link between metformin and the serine-threonine tumor suppressor, LKB1, as a mechanism for the reduced risk (113) (see Table 2).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [113]
In the citing paper
“A retrospective study published in 2005 reported that patients with diabetes who had been treated with metformin for T2DM had a lower risk of cancer and highlighted the possible link between metformin and the serine-threonine tumor suppressor, LKB1, as a mechanism for the reduced risk (113) (see Table 2).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [113]
In the citing paper
“Metformin may have additional anticancer properties independent of AMPK, liver kinase 1 (LKB1), and TSC2. This may be related, in part, to the inhibition of Rag GTPase-mediated activation of mTOR [145].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [145]
In the citing paper
“Patients with type 2 diabetes who are prescribed metformin had a lower risk of cancer compared to patients who did not take it.”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [145]
In the citing paper
“When compared to those on other treatments, metformin users had a lower risk of cancer. A dose-relationship has been reported [138,144,145].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [145]
In the citing paper
“The first observation that metformin might reduce the risk of cancer was made in a population-based case-control study of type 2 diabetic patients treated with metformin(253).”
From Metformin, the Aspirin of the 21st Century: Its Role in Gestational Diabetes Mellitus, Prevention of Preeclampsia and Cancer, and the Promotion of Longevity (2017) · cites this paper as [253]
In the citing paper
“PTEN-loss, a common genomic alteration associated with poorer outcomes, upregulates phosphatidylinositol 3kinase (PI3K)/protein kinase B (Akt) signaling, which promotes cancer cell proliferation [16].”
From Enzalutamide Plus Metformin Versus Enzalutamide Alone in Metastatic Castration-resistant Prostate Cancer: A Randomized Phase 2 Trial (SAKK 08/14). (2026) · cites this paper as [16]
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Citations
Cites
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Metadata
- Authors
- Evans, J. M. M., Donnelly, L. A., Emslie-Smith, A. M., Alessi, D. R., & Morris, A. D.
- Affiliations
- University of Dundee (GB)
- Corresponding author
- Evans, Josie M M
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2005-04-22
- Volume
- 330
- Issue
- 7503
- Pages
- 1304-1305
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC558205
- OpenAlex
- W2026967508
- Cited by
- 2,388
- References
- 2
- Citations by year
- 2026: 53 · 2025: 58 · 2024: 87 · 2023: 111 · 2022: 109 · 2021: 148 · 2020: 157 · 2019: 165 · 2018: 138 · 2017: 169 · 2016: 144 · 2015: 153 · 2014: 177 · 2013: 153 · 2012: 144
- FWCI
- 11.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (publishedVersion)
- Stirling Online Research Repository (University of Stirling) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- metformin, cancer risk, diabetes mellitus, cancer prevention, HIV surveillance, underreporting, heterosexual transmission, HIV diagnosis, voluntary reporting system, ethnic minorities
- MeSH terms
- Aged, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Metformin, Neoplasms, Pilot Projects, Risk Factors, Case-Control Studies
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