Evidence map›Metformin × adverse events & safety›PMID 27926481›Full record

SynthesisOncotarget2017

Metformin therapy and risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients: A systematic review and meta-analysis.

Feifei Liu, Lijing Yan, Zhan Wang, Yuanan Lu, Yuanyuan Chu, Xiangyu Li, Yisi Liu, Dongsheng Rui, Shaofa Nie, Hao Xiang

Open access · diamondFull text readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Oncotarget, 2017. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It also reports 2 associations that do not count as treatment evidence, such as OR 0.73 (0.62 to 0.86) for colorectal cancer risk. Cited by 48 papers, 7 of them syntheses that pooled it.

2numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 7 pooled it
5.6field-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.

Read, but not usablea number the graph found but could not read as for or against

Colorectal cancer riskmetformin therapyan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
OR 0.730.62 to 0.86p=0.0002
Besides, a significant reduction of colorectal cancer risk was also observed (unadjusted OR=0.73, 95% CI: 0.62-0.86, p=0.0002).
FeedsMetformin×adverse events & safety
Colorectal cancer riskmetformin users vs non-metformin users and other treatment usersan association or prognostic statement, not a treatment comparison · t2dfeeds one cell of the map
OR 0.780.70 to 0.87p<0.00001
And when the adjusted data were analyzed, colorectal cancer risk for metformin users was decreased with a reduction of 22%, compared with non-metformin users and other treatment users (adjusted OR=0.78, 95% CI: 0.70-0.87, p<0.00001).
FeedsMetformin×adverse events & safety

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×adverse events & safety

No readable resultOpen on the map →What to test next →

22 readable studies in this cell: 9 favour the treatment, 8 find no difference, 5 favour the comparator.

Belief with this paper
0.27contested · 4 families support, 11 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017190031,413 enrolled · 2012
Adjusted mean -0.72-0.95 to -0.48
NCT018093271,186 enrolled · 2013
Δ -0.40-0.59 to -0.21
NCT022730501,136 enrolled · 2014
Δ -8.90-13.3 to -4.50
NCT01126580807 enrolled · 2010
Δ -0.22-0.36 to -0.08
NCT01023581784 enrolled · 2009
Δ -0.67-0.96 to -0.37
NCT00386100688 enrolled · 2006
Δ 1.47-14.8 to 20.8
NCT01217073685 enrolled · 2010
Δ 1.00-9.80 to 13.1
NCT01890122647 enrolled · 2013
Δ -0.68-0.89 to -0.47
NCT00727857600 enrolled · 2007
Δ 0.860.51 to 1.22
NCT01958671461 enrolled · 2013
Δ -2.60-13.1 to 8.10
NCT00328172302 enrolled · 2006
Δ -0.85-1.10 to -0.59
NCT01485614200 enrolled · 2012
Δ 2.40-10.0 to 14.9

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

48 citing papers in PubMed, 7 syntheses or guidelines pooled it, 98 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. 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
  4. Pooled it
  5. Pooled it
  6. Metformin monotherapy for adults with type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2020 · on this map
    Pooled it
  7. Pooled it
  8. Trial
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Review
  17. A machine learning prediction model for cancer risk in patients with type 2 diabetes based on clinical tests.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024
    Article
  18. The Effect of Serum Leptin Concentration and Leptin Receptor Expression on Colorectal Cancer.International journal of environmental research and public health · 2023
    Article
  19. Review
  20. Article
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

10 authors at 5 institutions in 2 countries.

Feifei LiuDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
Lijing YanGlobal Health Research Center, Duke Kunshan university, Kunshan, Jiangsu, 215316, China.
Zhan WangGlobal Health Research Center, Duke Kunshan university, Kunshan, Jiangsu, 215316, China.
Yuanan LuEnvironmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, Honolulu, HI 96822 USA.
Yuanyuan ChuDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
Xiangyu LiDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
Yisi LiuDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
Dongsheng RuiDepartment Of Public Health, Medicial College Shihezi University, Shihezi city, 832000, China.
Shaofa NieDepartment of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Hao XiangDepartment of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430071, China.
Wuhan University · CNDuke Kunshan University · CNHuazhong University of Science and Technology · CNShihezi University · CNUniversity of Hawaiʻi at Mānoa · US

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.

Recent evidence indicates that metformin therapy may be associated with a decreased colorectal adenoma/colorectal cancer risk in type 2 diabetes patients. However, results are not consistent. We therefore performed a systematic review and meta-analysis to assess the association between metformin therapy and risk of colorectal adenomas/colorectal cancer in type 2 diabetes mellitus patients. We searched the literature published before Aug 31, 2016 in four databases: PubMed, Embase database, CNKI and VIP Library of Chinese Journal. Summary risk estimates (adjusted OR/adjusted RR/adjusted HR) with their 95% confidence interval (95% CI) were obtained using a random effects model. Twenty studies (including 12 cohort studies, 7 case-control studies and 1 randomized controlled trial study) were selected in terms of data of colorectal adenomas or colorectal cancer incidence. Metformin therapy was found to be associated with a decreased incidence of colorectal adenomas (unadjusted OR=0.80, 95% CI: 0.71-0.90, p=0.0002). When the adjusted data were analyzed, the summary estimate decreased to 25% reduction in colorectal adenomas risk (adjusted OR=0.75, 95% CI: 0.59-0.97, p=0.03). Besides, a significant reduction of colorectal cancer risk was also observed (unadjusted OR=0.73, 95% CI: 0.62-0.86, p=0.0002). And when the adjusted data were analyzed, colorectal cancer risk for metformin users was decreased with a reduction of 22%, compared with non-metformin users and other treatment users (adjusted OR=0.78, 95% CI: 0.70-0.87, p<0.00001). Our meta-analysis suggested that metformin therapy may be associated with a decreased risk of colorectal adenomas and colorectal cancer in type 2 diabetes mellitus patients.

Indexed as

AdenomaColorectal NeoplasmsDiabetes Mellitus, Type 2HumansMetforminMetformincolorectal adenomascolorectal cancermeta-analysismetformintype 2 diabetes mellitus

Identifiers

PMID27926481
PMCPMC5362542
OpenAlexW2558814374

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.