June 12, 2013. The journal Cancer Epidemiology, Biomarkers & Prevention published an article on June 10, 2013 which reports a benefit for the antidiabetic drug metformin in colorectal cancer survival. The study involved 3,816 men and women with stage I-III colorectal cancer diagnosed between 2001 and 2006, including 207 diabetics who had been prescribed metformin, 108 diabetics who did not use the drug and 3,501 nondiabetics. The subjects were followed through 2010, during which 196 deaths occurred among those with diabetes, and 1,897 occurred among the nondiabetics. Among the diabetic patients, 93 deaths were due to colorectal cancer, and 1,082 nondiabetic deaths were attributable to the disease.
When subjects treated with metformin were compared to diabetics who did not use the drug, a reduction in the risk of death due to colorectal cancer that "approached significance" was observed. However, those whose use of metformin was categorized as high intensity (higher dose), had a 56% lower risk of dying of the disease than diabetics who did not use the drug. Metformin use was additionally associated with a 31% lower adjusted risk of dying from any cause among diabetic subjects over follow-up.
"This study is the first, to the authors' knowledge, to assess the presence of an exposure response effect between increasing metformin use and colorectal cancer outcomes," authors Susan C. Spillane and her colleagues at St James Hospital in Dublin announce. "Significant associations were observed in stratified analyses of high intensity exclusive metformin usage and the results also suggest that metformin exposure may potentially improve survival relative to non-diabetic patients. Additional studies in larger population-based cohorts are required to further explore the influence of varying exposure levels and timing and to determine if any patient subgroups are more likely to benefit from metformin."
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