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Metformin use in cancer survivors with diabetes reduces all-cause mortality, based on the Korean National Health Insurance Service between 2002 and 2015

 Joungyoun Kim  ;  Yoon-Jong Bae  ;  Jae-Woo Lee  ;  Ye-Seul Kim  ;  Yonghwan Kim  ;  Hyo-Sun You  ;  Hyeong-Seop Kim  ;  Eun-A Choi  ;  Ye-Eun Han  ;  Hee-Taik Kang 
 MEDICINE, Vol.100(11) : e25045, 2021-03 
Journal Title
Issue Date
Adult ; Aged ; Cancer Survivors / statistics & numerical data ; Cause of Death ; Diabetes Mellitus / drug therapy* ; Diabetes Mellitus / mortality* ; Female ; Follow-Up Studies ; Humans ; Hypoglycemic Agents / therapeutic use* ; Kaplan-Meier Estimate ; Male ; Metformin / therapeutic use* ; Middle Aged ; National Health Programs / statistics & numerical data ; Neoplasms / complications ; Neoplasms / mortality* ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Treatment Outcome
Malignant neoplasms are the leading cause of death in Korea. We aimed to examine if metformin use in cancer survivors reduces all-cause mortality. This study was retrospectively designed based on data from the Korean National Health Insurance Service-National Health Screening Cohort (HEALS) between 2002 and 2015. The Kaplan-Meier estimator and log-rank test was performed to estimate the survival function according to metformin usage (3721 metformin non-users with diabetes, 5580 metformin users with diabetes, and 24,483 non-diabetic individuals). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were calculated using Cox proportional hazards regression models.The median follow-up duration was 4.2 years. The HRs (95% CIs) for all-cause mortality of metformin users and the non-diabetic group were 0.762 (0.683-0.850) and 1.055 (0.966-1.152) in men and 0.805 (0.649-0.999), and 1.049 (0.873-1.260) in women, respectively, compared with metformin non-users among diabetic cancer survivors, in a fully adjusted model. After stratifying metformin users into pre- and post-diagnosis of cancers, adjusted HRs (95% CIs) of pre- and post-diagnosis metformin users for all-cause mortality were 0.948 (0.839-1.071) and 0.530 (0.452-0.621) in men and 1.163 (0.921-1.469) and 0.439 (0.323-0.596) in women, respectively.Metformin use in cancer survivors with diabetes reduced overall mortality rates. In particular, metformin use after cancer diagnosis, not before cancer diagnosis, was inversely associated with overall mortality.Active treatment with metformin for diabetic cancer survivors after cancer diagnosis can improve their survival rates.
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3. College of Nursing (간호대학) > Dept. of Nursing (간호학과) > 1. Journal Papers
Yonsei Authors
Joungyoun Kim(김정연)
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