Metformin use and risk of cancer in patients with type 2 diabetes: a cohort study of primary care records using inverse probability weighting of marginal structural models | Zendy

Ruth Farmer | Zendy; Deborah Ford | Zendy; Rohini Mathur | Zendy; Nish Chaturvedi | Zendy; Richard Kaplan | Zendy; Liam Smeeth | Zendy; Krishnan Bhaskaran | Zendy

Open Access

Metformin use and risk of cancer in patients with type 2 diabetes: a cohort study of primary care records using inverse probability weighting of marginal structural models

Author(s) -

Ruth Farmer,

Deborah Ford,

Rohini Mathur,

Nish Chaturvedi,

Richard Kaplan,

Liam Smeeth,

Krishnan Bhaskaran

Publication year - 2019

Publication title -

international journal of epidemiology

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.406

H-Index - 208

eISSN - 1464-3685

pISSN - 0300-5771

DOI - 10.1093/ije/dyz005

Subject(s) - medicine , metformin , marginal structural model , confounding , cancer , hazard ratio , prostate cancer , body mass index , population , type 2 diabetes , inverse probability weighting , interquartile range , oncology , cohort , diabetes mellitus , confidence interval , endocrinology , environmental health , insulin , propensity score matching

Previous studies provide conflicting evidence on whether metformin is protective against cancer. When studying time-varying exposure to metformin, covariates such as body mass index (BMI) and glycated haemoglobin (HbA1c) may act as both confounders and causal pathway variables, and so cannot be handled adequately by standard regression methods. Marginal structural models (MSMs) with inverse probability of treatment weights (IPTW) can correctly adjust for such confounders. Using this approach, the main objective of this study was to estimate the effect of metformin on cancer risk compared with risk in patients with T2DM taking no medication.

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