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Use of statins offsets insulin‐related cancer risk
Author(s) -
KautzkyWiller A.,
Thurner S.,
Klimek P.
Publication year - 2017
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12567
Subject(s) - medicine , metformin , cancer , prostate cancer , type 2 diabetes , population , pancreatic cancer , insulin , diabetes mellitus , statin , oncology , endocrinology , environmental health
Aim There is firm evidence of a relation between type 2 diabetes (T2DM) and increased risks of cancer at various sites, but it is still unclear how different antihyperglycaemic therapies modify site‐specific cancer risks. The aim of this study was to provide a complete characterization of all possible associations between individual T2DM therapies, statin use and site‐specific cancers in the Austrian population. Methods Medical claims data of 1 847 051 patients with hospital stays during 2006–2007 were used to estimate age‐ and sex‐dependent co‐occurrences of site‐specific cancer diagnoses and treatment with specific glucose‐lowering drugs and statins. Results Patients treated with insulin or insulin secretagogues showed up to ninefold increased risks for cancers of the colon [males only (m)], liver (m), pancreas, lung (m) and brain (m), as well as a strongly decreased risk for prostate cancer (m). In patients taking statins, the risks were generally decreased, with a greater risk reduction in patients not receiving antihyperglycaemic therapies. The strongest effects were observed for use of insulin and pancreatic cancer [m: OR 4.5, 95% CI: 3.1–6.6; females (f): OR 4.2, 95% CI: 2.5–7.1], sulfonylureas (m: OR 2.8, 95% CI: 1.7–4.6; f: OR 3.0, 95% CI: 2.1–4.2) or glitazones and skin cancer (f: OR 0.54, 95% CI: 0.36–0.80), as well as metformin and cancer of the prostate (m: OR 0.82, 95% CI: 0.75–0.91) and corpus uteri (f: OR 1.7, 95% CI: 1.4–2.0) and non‐Hodgkin's lymphoma (f: OR 0.76, 95% CI: 0.64–0.91). Conclusions The use of statins offsets insulin‐related cancer risks in patients with diabetes independently of sex and age. Overall, our data support the hyperglycaemia–cancer hypothesis. A reduction in endogenous or exogenous hyperinsulinaemia may be beneficial for cancer prevention. Therefore, insulin‐sparing and insulin‐sensitizing drugs should be the preferred treatment choices.