Abstract PD03-03: Metformin and Cancer Risk in Diabetic Patients: A Systematic Review and Meta-Analysis, with Special Emphasis to Breast Cancer
Notice bibliographique
Résumé
Abstract Background: Metformin (M), an insulin-lowering agent, has been associated with decreased cancer risk in epidemiological studies in diabetic patients in comparison with other antidiabetic treatments. Methods: We performed a comprehensive literature search and meta-analysis of epidemiological studies to assess the effect of M on cancer incidence and mortality in diabetic patients, using Pubmed, ISI-Web of Science (Science Citation Index Expanded), Embase, and the Cochrane library until June 2010, with no language or time restrictions. A manual search was also done for references cited in the selected articles, reviews or books. Published independent reports with sufficient information to allow adequate risk estimation of cancer risk/mortality and a corresponding measure of uncertainty after M use compared with other diabetic treatments were reviewed. Association between M and cancer incidence/mortality was computed as a summary relative risk (SRR) with 95% confidence intervals. Random effects models were applied to take into account heterogeneity. Sensitivity analyses were carried out to verify stability of the estimates. Publication bias was investigated using funnel plots and the Macaskill regression test. Results: Eleven studies were selected for relevance in terms of intervention, population studied, independence and reporting of cancer incidence or mortality data, reporting 4042 cancer events and 529 cancer deaths. A significant 31% reduction (overall SRR=0.69, 95%CI, 0.61-0.79) was found in subjects taking M compared with other antidiabetic drugs. The protective effect was significant for pancreatic and hepatocellular cancer, and non-significant trends were noted for colon, and prostate and breast cancer (BC). A non significant protective effect of M on BC incidence was found (SRR=0.75, 95% CI, 0.44-1.29; p for heterogeneity = 0.09, I2=59%). Conclusion: Among diabetics, M use is associated with a significant inverse association with any cancer incidence and a promising trend on BC incidence as compared with other diabetic treatments, including insulin. Further prospective studies of M as a cancer preventive agent are warranted. For breast cancer, Libby et al (Diabetes Care 2009;32:1620-25) found a non-significant trend for a protective effect on M users vs. not users (HR=0.6, 0.32-1.10), whereas Currie et al (Diabetologia 2009;52:1766- 77) noted a weak trend when M was a concomitant treatment among glargine users vs. all other insulin regimens (HR=0.88, 0.48-1.63), or when metformin was given as a monotherapy vs. insulin-based regimens (HR=0.93, 0.69-1.27). No effect was found when M monotherapy was compared with sulphonylureas (HR=1.02, 0.71-1.45). Bodmer et al (Diabetes Care 2010;33:1304-8) found a significant protective effect (OR=0.44, 0.24-0.82) only with a long term use of M, defined as equal to approximately 5+ years. The SRR for M and BC risk is plotted in figure. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD03-03.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,013 | 0,030 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,015 | 0,031 |
| Bibliométrie | 0,009 | 0,010 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».