Association Between Metformin Use and Risk of Esophageal Squamous Cell Carcinoma in a Population-Based Cohort Study
Wang, Qiao-Li LU
; Santoni, Giola
; Ness-Jensen, Eivind
; Lagergren, Jesper
and Xie, Shao-Hua
(2020)
In The American journal of gastroenterology
115(1).
p.73-78
- Abstract
OBJECTIVES: Esophageal cancer is a highly fatal malignant neoplasm, with 2 etiologically different histological types. A large prospective study is expected to elucidate the specific risk of the 90% subtype of esophageal cancer, esophageal squamous cell carcinoma (ESCC), with metformin therapy. This study aims to determine the association between metformin use and incident ESCC risk.
METHODS: This was a nationwide population-based prospective cohort study conducted in Sweden in 2005-2015. Among 8.4 million participants identified in the cohort, 411,603 (5%) were metformin users. The users were compared with 10 times as many frequency-matched nonusers of metformin (n = 4,116,030) by age and sex. Metformin use was treated as a... (More)
OBJECTIVES: Esophageal cancer is a highly fatal malignant neoplasm, with 2 etiologically different histological types. A large prospective study is expected to elucidate the specific risk of the 90% subtype of esophageal cancer, esophageal squamous cell carcinoma (ESCC), with metformin therapy. This study aims to determine the association between metformin use and incident ESCC risk.
METHODS: This was a nationwide population-based prospective cohort study conducted in Sweden in 2005-2015. Among 8.4 million participants identified in the cohort, 411,603 (5%) were metformin users. The users were compared with 10 times as many frequency-matched nonusers of metformin (n = 4,116,030) by age and sex. Metformin use was treated as a time-varying variate, and multivariable cause-specific proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for ESCC, adjusted for age, sex, calendar year, residence area, tobacco smoking, alcohol overconsumption, and use of nonsteroidal anti-inflammatory drugs or statins.
RESULTS: The incidence rates of ESCC were 3.5 per 100,000 person-years among the metformin users and 5.3 per 100,000 person-years in the nonusers. Metformin users overall were at a decreased risk of ESCC compared with nonusers (HR 0.68, 95% CI 0.54-0.85). The decrease in risk was more pronounced in new metformin users (HR 0.44, 95% CI 0.28-0.64) and participants aged 60-69 years (HR 0.45, 95% CI 0.31-0.66).
DISCUSSION: Metformin use decreases the risk of developing ESCC.
(Less)
- author
- Wang, Qiao-Li
LU
; Santoni, Giola
; Ness-Jensen, Eivind
; Lagergren, Jesper
and Xie, Shao-Hua
- publishing date
- 2020-01
- type
- Contribution to journal
- publication status
- published
- keywords
- Esophageal Neoplasms/diagnosis, Esophageal Squamous Cell Carcinoma/diagnosis, Female, Follow-Up Studies, Humans, Hypoglycemic Agents/pharmacology, Incidence, Male, Metformin/pharmacology, Middle Aged, Patient Compliance, Population Surveillance, Prognosis, Prospective Studies, Registries, Risk Assessment/methods, Risk Factors, Sweden/epidemiology
- in
- The American journal of gastroenterology
- volume
- 115
- issue
- 1
- pages
- 73 - 78
- publisher
- Wolters Kluwer
- external identifiers
-
- pmid:31821177
- scopus:85077476522
- ISSN
- 1572-0241
- DOI
- 10.14309/ajg.0000000000000478
- language
- English
- LU publication?
- no
- id
- 948a693f-4911-44af-b8bd-d7e14478906a
- date added to LUP
- 2025-05-12 17:01:09
- date last changed
- 2025-06-24 07:46:23
@article{948a693f-4911-44af-b8bd-d7e14478906a,
abstract = {{<p>OBJECTIVES: Esophageal cancer is a highly fatal malignant neoplasm, with 2 etiologically different histological types. A large prospective study is expected to elucidate the specific risk of the 90% subtype of esophageal cancer, esophageal squamous cell carcinoma (ESCC), with metformin therapy. This study aims to determine the association between metformin use and incident ESCC risk.</p><p>METHODS: This was a nationwide population-based prospective cohort study conducted in Sweden in 2005-2015. Among 8.4 million participants identified in the cohort, 411,603 (5%) were metformin users. The users were compared with 10 times as many frequency-matched nonusers of metformin (n = 4,116,030) by age and sex. Metformin use was treated as a time-varying variate, and multivariable cause-specific proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for ESCC, adjusted for age, sex, calendar year, residence area, tobacco smoking, alcohol overconsumption, and use of nonsteroidal anti-inflammatory drugs or statins.</p><p>RESULTS: The incidence rates of ESCC were 3.5 per 100,000 person-years among the metformin users and 5.3 per 100,000 person-years in the nonusers. Metformin users overall were at a decreased risk of ESCC compared with nonusers (HR 0.68, 95% CI 0.54-0.85). The decrease in risk was more pronounced in new metformin users (HR 0.44, 95% CI 0.28-0.64) and participants aged 60-69 years (HR 0.45, 95% CI 0.31-0.66).</p><p>DISCUSSION: Metformin use decreases the risk of developing ESCC.</p>}},
author = {{Wang, Qiao-Li and Santoni, Giola and Ness-Jensen, Eivind and Lagergren, Jesper and Xie, Shao-Hua}},
issn = {{1572-0241}},
keywords = {{Esophageal Neoplasms/diagnosis; Esophageal Squamous Cell Carcinoma/diagnosis; Female; Follow-Up Studies; Humans; Hypoglycemic Agents/pharmacology; Incidence; Male; Metformin/pharmacology; Middle Aged; Patient Compliance; Population Surveillance; Prognosis; Prospective Studies; Registries; Risk Assessment/methods; Risk Factors; Sweden/epidemiology}},
language = {{eng}},
number = {{1}},
pages = {{73--78}},
publisher = {{Wolters Kluwer}},
series = {{The American journal of gastroenterology}},
title = {{Association Between Metformin Use and Risk of Esophageal Squamous Cell Carcinoma in a Population-Based Cohort Study}},
url = {{http://dx.doi.org/10.14309/ajg.0000000000000478}},
doi = {{10.14309/ajg.0000000000000478}},
volume = {{115}},
year = {{2020}},
}