Evidence map›Metformin × all-cause mortality›PMID 26886616›Full record

SynthesisMedicine2016

Metformin Is Associated With Slightly Reduced Risk of Colorectal Cancer and Moderate Survival Benefits in Diabetes Mellitus: A Meta-Analysis.

Xing-Kang He, Ting-Ting Su, Jian-Min Si, Lei-Min Sun

Open access · goldFull text readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Medicine, 2016. The graph read 1 number from its abstract, feeding 1 cell of the map: it finds no clear difference in 1. Cited by 34 papers, 10 of them syntheses that pooled it.

1number the graph read from it
1cell of the map it votes in
34citing papers in PubMed, 10 pooled it
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
0.524101 · no effect
All-cause mortalityno clear difference · against placebo · t2dfeeds one cell of the map
HR 0.680.58 to 81.0
Furthermore, the pooled hazard ratio (HR) revealed an improved survival outcome for metformin users in CRC patients compared to nonusers (HR = 0.68, 95% CI: 0.58-081).
FeedsMetformin×all-cause mortality

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×all-cause mortality

InconclusiveOpen on the map →What to test next →

1 readable study in this cell: 0 favour the treatment, 1 find no difference, 0 favour the comparator.

Belief with this paper
0.25no deciding trial · 0 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT000387272,779 enrolled · 1996
HR 0.990.79 to 1.25

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

34 citing papers in PubMed, 10 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  2. Pooled it
  3. Pooled it
  4. The effect of metformin on gastric cancer in patients with type 2 diabetes: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020 · on this map
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Article
  13. Associations between Diabetes Mellitus and Selected Cancers.International journal of molecular sciences · 2024
    Review
  14. Review
  15. Article
  16. Insulin Resistance: The Increased Risk of Cancers.Current oncology (Toronto, Ont.) · 2024
    Review
  17. Review
  18. Article
  19. Article
  20. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Xing-Kang HeFrom the Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University Medical School (X-KH, T-TS, J-MS, L-MS); and Institute of Gastroenterology, Zhejiang University (IGZJU), Hangzhou, P. R. China (X-KH, T-TS, J-MS, L-MS).
Ting-Ting Su
Jian-Min Si
Lei-Min Sun
Sir Run Run Shaw Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

To systematically assess the effect of metformin on colorectal cancer (CRC) risk and mortality in type 2 diabetes mellitus (T2DM) patients. We conducted a systematic search of PubMed, Web of Science, and the Cochrane Library databases for relevant articles before August 2015. Two investigators identified and extracted data independently. We adopted adjusted estimates to calculate summary estimates with 95% confidence interval (CI) using either a fixed-effects or a random-effects model. Subgroup and sensitivity analyses were conducted to evaluate the robustness of the pooled results. The risk of publication bias was assessed by examining funnel plot asymmetry as well as Begg test and Egger test. Fifteen studies on CRC incidence and 6 studies on CRC survival were finally included in our meta-analysis. The pooled odds ratio (OR) of observational studies illustrated that a slight 10% reduction of CRC incidence was associated with metformin use (OR = 0.90, 95% CI: 0.85-0.96). Furthermore, the pooled hazard ratio (HR) revealed an improved survival outcome for metformin users in CRC patients compared to nonusers (HR = 0.68, 95% CI: 0.58-081). There was no publication bias across studies. Our meta-analysis demonstrated that metformin therapy could slightly reduce CRC incidence and moderately improve the survival outcomes in patients with T2DM. More prospective studies are warranted to certify this protective association.

Indexed as

Colorectal NeoplasmsDiabetes Mellitus, Type 2HumansHypoglycemic AgentsMetforminHypoglycemic AgentsMetformin

Identifiers

PMID26886616
PMCPMC4998616
OpenAlexW2285738189

What OpenQuestion holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.