Evidence map›Paper›PMID 30022336›Full record

ArticleCancer causes & control : CCC2018

Metformin use and incidence cancer risk: evidence for a selective protective effect against liver cancer.

Harvey J Murff, Christianne L Roumie, Robert A Greevy, Amber J Hackstadt, Lucy E D'Agostino McGowan, Adriana M Hung, Carlos G Grijalva, Marie R Griffin

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer causes & control : CCC, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 13 pooled it
3.3field-weighted citation impact, top 7% 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.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · 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.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 13 syntheses or guidelines pooled it, 66 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. The effect of metformin on esophageal cancer risk in patients with type 2 diabetes mellitus: 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 · 2021 · on this map
    Pooled it
  10. Pooled it
  11. 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
  12. Metformin and colorectal cancer: a systematic review, meta-analysis and meta-regression.International journal of colorectal disease · 2020 · on this map
    Pooled it
  13. Pooled it
  14. Metformin and Gastric Carcinogenesis: Stage-Specific Effects?The Korean journal of helicobacter and upper gastrointestinal research · 2026
    Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

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

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Harvey J MurffVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA. Harvey.j.murff@vanderbilt.edu.
Christianne L RoumieVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA.
Robert A GreevyVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA.
Amber J HackstadtDepartment of Biostatistics, Vanderbilt University, Nashville, TN, USA.
Lucy E D'Agostino McGowanDepartment of Biostatistics, Vanderbilt University, Nashville, TN, USA.
Adriana M HungVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA.
Carlos G GrijalvaVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA.
Marie R GriffinVeterans Health Administration-Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA.
VA Tennessee Valley Healthcare System · USVanderbilt University · USVeterans Health Administration · USVanderbilt Health · US

Funding

Vanderbilt Center for Diabetes Translation ResearchP30DK092986 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WILKINS, CONSUELO HOPKINS · 2011 to 2020
$6.7M
Opioid selection and the risk of serious infections in older adultsR01AG043471 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G · 2013 to 2017
$2.3M
Fatty acid desaturase activity, fish oil and colorectal cancer chemopreventionR01CA160938 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI MURFF, HARVEY J. · 2011 to 2014
$1.3M
Long-Chain Fatty Acids, Oxidative Stress and Colorectal Neoplasm RiskR01CA143288 · NCI · VANDERBILT UNIVERSITY · PI MURFF, HARVEY J. · 2010 to 2013
$1.0M
PPAR-gamma and BPH/LUTSP20DK090874 · NIDDK · VANDERBILT UNIVERSITY · PI HAYWARD, SIMON W · 2010 to 2011
$868k
Optimal first line therapies for patients with Cardiovascular-Kidney-Metabolic (CKM) Syndrome.I01CX000570 · VA · VETERANS HEALTH ADMINISTRATION · PI ROUMIE, CHRISTIANNE L. · 2013 to 2025
–
CSRD VA I01 CX000570NCI NIH HHS CA143288NCI NIH HHS CA160938NCI NIH HHS R01 CA143288NCI NIH HHS R01 CA160938NIA NIH HHS AG043471NIA NIH HHS R01 AG043471NIDDK NIH HHS DK092986NIDDK NIH HHS P20 DK090874NIDDK NIH HHS P30 DK092986
6 · The paper itself

Abstract

purposeSeveral observational studies suggest that metformin reduces incidence cancer risk; however, many of these studies suffer from time-related biases and several cancer outcomes have not been investigated due to small sample sizes.

methodsWe constructed a propensity score-matched retrospective cohort of 84,434 veterans newly prescribed metformin or a sulfonylurea as monotherapy. We used Cox proportional hazard regression to assess the association between metformin use compared to sulfonylurea use and incidence cancer risk for 10 solid tumors. We adjusted for clinical covariates including hemoglobin A1C, antihypertensive and lipid-lowering medications, and body mass index. Incidence cancers were defined by ICD-9-CM codes.

resultsAmong 42,217 new metformin users and 42,217 matched-new sulfonylurea users, we identified 2,575 incidence cancers. Metformin was inversely associated with liver cancer (adjusted hazard ratio [aHR] = 0.44, 95% CI 0.31, 0.64) compared to sulfonylurea. We found no association between metformin use and risk of incidence bladder, breast, colorectal, esophageal, gastric, lung, pancreatic, prostate, or renal cancer when compared to sulfonylurea use.

conclusionsIn this large cohort study that accounted for time-related biases, we observed no association between the use of metformin and most cancers; however, we found a strong inverse association between metformin and liver cancer. Randomized trials of metformin for prevention of liver cancer would be useful to verify these observations.

Indexed as

AgedCarcinoma, HepatocellularFemaleHumansHypoglycemic AgentsIncidenceLiver NeoplasmsMaleMetforminMiddle AgedProportional Hazards ModelsRetrospective StudiesRiskSulfonylurea CompoundsUnited StatesVeteransHypoglycemic AgentsMetforminSulfonylurea CompoundsCancerDiabetes mellitusMetforminSulfonylureas

Identifiers

PMID30022336
PMCPMC6108939
OpenAlexW2884090045

What OpenQuestion holds

Textmetadata
LicenceTDM
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.