Trial reportCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2021

Antidiabetic Drugs and Prostate Cancer Prognosis in a Finnish Population-Based Cohort.

Ville J Vihervuori, Kirsi Talala, Kimmo Taari, Jorma Lahtela, Teuvo L J Tammela, Anssi Auvinen, Paavo Raittinen, Teemu J Murtola

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2021. The graph read 1 number from its abstract, feeding 3 cells of the map: it supports the treatment in 3. Cited by 4 papers.

1number the graph read from it
3cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 42% 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 →
1 · no effect
Adverse events & safetyfavours the comparator · against placebo · t2dfeeds 3 cells of the map
HR 1.421.18 to 1.70
RESULTS: Risk of prostate cancer death was higher among antidiabetic drug users overall (HR = 1.42; 95% CI, 1.18-1.70) compared with nonusers, separately among insulin and metformin users.

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.

Insulin×adverse events & safety

SupportsOpen on the map →What to test next →

16 readable studies in this cell: 7 favour the treatment, 5 find no difference, 4 favour the comparator.

Belief with this paper
0.09contested · 1 family supports, 8 contradict · against placebo
Without it
0.00This paper moves it by +0.09.
← favours the treatmentfavours the comparator →
1 · no effect
This paper · 2021
HR 1.421.18 to 1.70

Metformin×adverse events & safety

SupportsOpen on the map →What to test next →

22 readable studies in this cell: 8 favour the treatment, 8 find no difference, 6 favour the comparator.

Belief with this paper
0.27contested · 4 families support, 11 contradict · against placebo
Without it
0.21This paper moves it by +0.05.
← favours the treatmentfavours the comparator →
1 · no effect
This paper · 2021
HR 1.421.18 to 1.70
NCT02932475831 enrolled · 2017
OR 0.860.63 to 1.19
NCT02980276535 enrolled · 2017
OR 0.530.27 to 1.01

Other glucose-lowering×adverse events & safety

SupportsOpen on the map →What to test next →

3 readable studies in this cell: 0 favour the treatment, 1 find no difference, 2 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itThis paper is the only evidence family behind the claim. Without it there is no number.
← favours the treatmentfavours the comparator →
1 · no effect
This paper · 2021
HR 1.421.18 to 1.70
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

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. 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

8 authors at 6 institutions in 1 country.

Ville J VihervuoriFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland. ville.vihervuori@tuni.fi.ORCID 0000-0003-4204-9155
Kirsi TalalaFinnish Cancer Registry, Helsinki, Finland.
Kimmo TaariDepartment of Urology, Helsinki University and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-0077-4896
Jorma LahtelaDepartment of Internal Medicine, Tampere University Hospital, Tampere, Finland.
Teuvo L J TammelaFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Anssi AuvinenFaculty of Social Sciences, Tampere University, Tampere, Finland.ORCID 0000-0003-1125-4818
Paavo RaittinenAalto University, Helsinki, Finland.
Teemu J MurtolaFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.ORCID 0000-0003-2932-9590
Tampere University · FIAalto University · FIFinnish Cancer Registry · FITampere University · FITampere University Hospital · FIUniversity of Helsinki · FI

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.

backgroundHyperinsulemia and glycemic control may play a role as prostate cancer prognostic factors, whereas use of certain antidiabetic drugs, that is metformin, could improve the prognosis. We examined the link between antidiabetic medication use and prostate cancer survival taking into account simultaneous use of multiple drugs.

methodsThe study cohort composed of 6,537 men in The Finnish Randomized Study of Screening for Prostate Cancer with prostate cancer diagnosed 1996 to 2009. Use of medication was attained from the nationwide prescription database of the Social Insurance Institution of Finland. Median follow-up was 9.2 years postdiagnosis. A total of 1,603 (24,5%) men had used antidiabetic medication. A total of 771 men died of prostate cancer during the follow-up. We used multivariable-adjusted Cox regression to evaluate the risk of prostate cancer death and onset of androgen deprivation therapy (ADT) with adjustment for prostate cancer clinical characteristics, comorbidities and use of other drugs. Separate analyses were further adjusted for blood glucose.

resultsRisk of prostate cancer death was higher among antidiabetic drug users overall (HR = 1.42; 95% CI, 1.18-1.70) compared with nonusers, separately among insulin and metformin users. Adjustment for blood glucose level abolished the risk increase. Risk of ADT initiation was increased among the medication users (HR = 1.26; 95% CI, 1.05-1.49).

conclusionsMen with prostate cancer using antidiabetic medication are generally at increased risk of dying from prostate cancer compared with nonusers. The risk association is driven by underlying diabetes, as adjustment for blood glucose level ameliorates the risk increase. IMPACT: Type 2 diabetes should be considered as a risk factor when considering prostate cancer prognosis.

Indexed as

AgedBlood GlucoseDiabetes Mellitus, Type 2FinlandGlycemic ControlHumansHypoglycemic AgentsInsulinMaleMetforminMiddle AgedProportional Hazards ModelsProstatic NeoplasmsRegistriesRisk AssessmentBlood GlucoseHypoglycemic AgentsInsulinMetformin

Identifiers

PMID33653815
OpenAlexW3134810121

What OpenQuestion holds

Texttitle and abstract
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.