Are Metformin or Statins Associated with Increased Risk for Ovarian Cancer in Women with Type 2 Diabetes?
BACKGROUND AND PURPOSE:
There are previous reports of reduced risk of cancers, including ovarian cancer in individuals with type 2 diabetes (T2D) being managed with metformin
Statin use has also been associated with reduced risk of cancer in some papers while there are other reports of women with T2D having an increased incidence of various cancers, including ovarian cancer especially in those treated with insulin
Many of these studies had methodological flaws, including smaller sample sizes
Urpilainen et al. (BJOG, 2018) assessed the impact of metformin and statin use on rates of ovarian cancer in women with type 2 diabetes (T2D)
The authors used 2 different study designs
Data was obtained from the diabetes database (FinDM) combining information from several Finnish nationwide registers
Women were over 40 years old and diagnosed with T2D
Hazard ratio (HR) was used to determine the relationship between ovarian cancer and ever use of
Other anti-diabetic medication
Case Control Study
20 controls were matched to each case of ovarian cancer
Conditional logistic regression was used to estimate HRs in relation to medication use and cumulative use of different medications
Data was collected from 137,643 women (mean follow up 5.4 years)
303 women were diagnosed with ovarian cancer
Incidence of ovarian cancer was highest in women age 60-69 years
For the case control study, 6060 controls were matched to the 303 cases of ovarian cancer based on age and T2D duration
Compared with other forms of oral anti-diabetic medication, metformin was not found to be associated with the incidence of ovarian cancer
HR 1.02; 95% CI, 0.72-1.45
There was also no evidence that statins affect the incidence of ovarian cancer
HR 0.99, 95% CI: 0.78-1.25
In the nested case-control analysis, the results were similar and no associations were found between metformin or statins and ovarian cancer
There was no increased risk of ovarian cancer in women with T2D treated with insulin
There was no measured association between the use of metformin or statins and risk for ovarian cancer in women with T2D
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