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International Journal of Colorectal Disease

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01-08-2020 | Metformin | Review

Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression

Authors: Cheng-Ann Winston Ng, Amy Aimei Jiang, Emma Min Shuen Toh, Cheng Han Ng, Zhi Hao Ong, Siyu Peng, Hui Yu Tham, Raghav Sundar, Choon Seng Chong, Chin Meng Khoo

Published in: International Journal of Colorectal Disease | Issue 8/2020

Abstract

Purpose

Metformin may have a role in reducing the incidence of colorectal cancer (CRC) and improving survival outcome. This meta-analysis explored the effect of metformin use on colorectal adenoma and cancer incidence, and colorectal oncological outcomes.

Methods

A database search was conducted on Medline, Embase and CNKI for studies comparing metformin vs. non-metformin users, metformin users vs. non-diabetics and metformin users vs. diabetics with diet-only treatment. Meta-analysis was done with DerSimonian and Laird with risk ratios (RR), and hazard ratios (HR) for survival outcomes.

Results

We included 58 studies and summarized incidences of colorectal adenoma and cancer, as well as cancer survival outcomes. Metformin users had a significant lower incidence of colorectal adenoma (RR 0.77, CI 0.67–0.88, p < 0.001), advanced adenoma (0.61, CI 0.42–0.88, p = 0.008) and CRC (RR 0.76, CI 0.69–0.84, p < 0.001) respectively compared with non-metformin users. Overall survival (HR 0.6, CI 0.53–0.67, p < 0.001) and CRC-specific survival (HR 0.66, CI 0.59–0.74, p < 0.001) were higher among metformin users compared with non-metformin users. Further analysis on overall survival of metastatic CRC patients revealed significantly higher survival rates in metformin users (HR 0.77, CI 0.68–0.87, p < 0.001).

Conclusion

This meta-analysis showed that metformin use significantly reduces colorectal adenoma and cancer incidence and improves colorectal cancer outcomes.

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Title: Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression
Authors: Cheng-Ann Winston Ng
Amy Aimei Jiang
Emma Min Shuen Toh
Cheng Han Ng
Zhi Hao Ong
Siyu Peng
Hui Yu Tham
Raghav Sundar
Choon Seng Chong
Chin Meng Khoo
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metformin
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 8/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03676-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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