Incidence of Bladder Cancer in Patients With Type 2 Diabetes Treated With Metformin or Sulfonylureas
Open accessAbstract
OBJECTIVE: Previous studies evaluating the effect of metformin on cancer risk have been impacted by time-related biases. To avoid these biases, we examined the incidence of bladder cancer in new users of metformin and sulfonylureas (SUs). RESEARCH DESIGN AND METHODS: This cohort study included 87,600 patients with type 2 diabetes in The Health Improvement Network database. Use of metformin or an SU was treated as a time-dependent variable. Cox regression-generated hazard ratios (HRs) compared metformin use with SU use, adjusted for age, sex, smoking, obesity, and HbA1c level. RESULTS: We identified 196 incident bladder cancers in the metformin cohort and 66 cancers in the SU cohort. Use of metformin was not associated with decreased bladder cancer risk (HR 0.81 [95% CI 0.60-1.09]). This association did not differ by sex (P for interaction = 0.20). We observed no association with duration of metformin relative to SU use (3 to <4 years of use: 0.57 [0.25-1.34]; 4 to <5 years of use: 0.93 [0.30-2.85; ≥5 years of use: 1.18 [0.44-3.19]; P for trend = 0.26). CONCLUSIONS: Use of metformin is not associated with a decreased incidence of bladder cancer. Similar methods should be used to study other cancers that have previously been identified as potentially preventable with metformin.
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No association has been shown between the use of metformin and a lower incidence of bladder cancer.
“For instance, no association has been shown between the use of metformin and a lower incidence of bladder cancer and concerns have also been expressed how data from observational studies are analyzed (239, 240).”
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 [239]
Concerns have been expressed about how data from observational studies are analyzed.
“For instance, no association has been shown between the use of metformin and a lower incidence of bladder cancer and concerns have also been expressed how data from observational studies are analyzed (239, 240).”
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 [239]
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- Authors
- Mamtani, R., Pfanzelter, N., Haynes, K., Finkelman, B. S., Wang, X., Keefe, S. M., Haas, N. B., Vaughn, D. J., & Lewis, J. D.
- Affiliations
- Abramson Cancer Center (US)
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
- University of Pennsylvania (US)
- Corresponding author
- Mamtani, Ronac
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2014-06-12
- Volume
- 37
- Issue
- 7
- Pages
- 1910-1917
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4067396
- OpenAlex
- W2151190595
- Cited by
- 71
- References
- 43
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 8 · 2017: 9 · 2016: 9 · 2015: 7 · 2014: 6
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Amgen
- Bristol-Myers Squibb
- Eli Lilly and Company
- AstraZeneca
- National Institutes of Health (K24-DK)
- National Heart, Lung, and Blood Institute (F30HL115992)
- National Cancer Institute (K12CA076931)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK078228)
- National Center for Research Resources (UL1RR024134)
- Janssen Pharmaceuticals
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Surgery › Bladder and Urothelial Cancer Treatments
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Keywords
- bladder cancer, metformin, sulfonylureas, type 2 diabetes, cancer risk, drug safety, incidence, time-dependent bias
- MeSH terms
- Aged, Urinary Bladder Neoplasms, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Neoplasms, Retrospective Studies, Sulfonylurea Compounds, Cohort Studies, Incidence, Databases, Factual
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