TY - JOUR
T1 - Risk of cancer in patients using glucose-lowering agents
T2 - a nationwide cohort study of 3.6 million people
AU - Andersson, Charlotte
AU - Vaag, Allan
AU - Selmer, Christian
AU - Schmiegelow, Michelle
AU - Sørensen, Rikke
AU - Lindhardsen, Jesper
AU - Gislason, Gunnar H
AU - Køber, Lars
AU - Torp-Pedersen, Christian
PY - 2012
Y1 - 2012
N2 - Objectives: To study the association between exposures to glucose-lowering therapy and risk of cancer using the nationwide administrative registers in Denmark. Design: Nationwide cohort study. Setting: All hospitals in Denmark. Participants: All individuals aged ≥35 years in 1998-2009 who were naive to glucose-lowering treatment and had no history of cancer. Primary measures outcomes: first cancer diagnosis between 1998 and 2009. The RR of cancer as dependent on exposure to individual glucose-lowering agents was assessed by multivariable Poisson regression models. Results: Of 159 894 patients that initiated treatment with glucose-lowering agents, 12 789 developed cancer, incidence rate 17.4/1000 person-years. Of the remaining 3 447 904 individuals not using glucose-lowering agents, 293 878 developed cancer, incidence rate 7.9/1000 person-years. Use of different types of glucose-lowering agents including human insulin, insulin analogues, as well as sulfonylureas were associated with a quantitatively similar and significantly increased RR of cancer of 1.2-1.3 compared with unexposed individuals after multivariable adjustment. For the majority of agents, the authors identified the highest RR of cancer during the first 30 treatment days with a subsequent decline of risk approaching the cancer risk of the background population only 6-12 months after initiation of treatments. Conclusions: Use of most glucose-lowering agents including sulfonylureas was associated with a comparable increased risk of cancer shortly after initiation of treatment and subsequently a decline to the risk of the background population. This suggests that the relation is not causal.
AB - Objectives: To study the association between exposures to glucose-lowering therapy and risk of cancer using the nationwide administrative registers in Denmark. Design: Nationwide cohort study. Setting: All hospitals in Denmark. Participants: All individuals aged ≥35 years in 1998-2009 who were naive to glucose-lowering treatment and had no history of cancer. Primary measures outcomes: first cancer diagnosis between 1998 and 2009. The RR of cancer as dependent on exposure to individual glucose-lowering agents was assessed by multivariable Poisson regression models. Results: Of 159 894 patients that initiated treatment with glucose-lowering agents, 12 789 developed cancer, incidence rate 17.4/1000 person-years. Of the remaining 3 447 904 individuals not using glucose-lowering agents, 293 878 developed cancer, incidence rate 7.9/1000 person-years. Use of different types of glucose-lowering agents including human insulin, insulin analogues, as well as sulfonylureas were associated with a quantitatively similar and significantly increased RR of cancer of 1.2-1.3 compared with unexposed individuals after multivariable adjustment. For the majority of agents, the authors identified the highest RR of cancer during the first 30 treatment days with a subsequent decline of risk approaching the cancer risk of the background population only 6-12 months after initiation of treatments. Conclusions: Use of most glucose-lowering agents including sulfonylureas was associated with a comparable increased risk of cancer shortly after initiation of treatment and subsequently a decline to the risk of the background population. This suggests that the relation is not causal.
U2 - 10.1136/bmjopen-2011-000433
DO - 10.1136/bmjopen-2011-000433
M3 - Journal article
C2 - 22685218
SN - 2044-6055
VL - 2
JO - BMJ Open
JF - BMJ Open
IS - 3
ER -
