Metformin use associated with lower mortality risk over 3.9 year median follow-up in diabetic women with cervical cancer

Tuesday, March 1, 2016

The March 2016 issue of Cancer Epidemiology, Biomarkers & Prevention reported an association between the use of metformin and a lower risk of mortality from cervical cancer among women diagnosed with the disease.

Kathy Han of Princess Margaret Cancer Centre and her Toronto colleagues utilized health care databases to identify 181 diabetic women aged 66 and older who were diagnosed with cervical cancer from 1997 to 2010. Cumulative metformin dose following diagnosis was calculated by multiplying dose and quantity of tablets dispensed with each prescription until the last follow-up date.

Over a 3.9 year median, a total of 129 deaths occurred, among which 61 were attributed to cervical cancer.  Dr Han's team uncovered a 21.4% lower risk of dying from cervical cancer and a 5% lower risk of all-cause mortality in association with each additional 365 grams of cumulative metformin use.

As potential mechanisms, the authors note that metformin has been found to impact signaling pathways involved in cervical cancer growth, sensitize cancer cells to radiotherapy and decrease tumor hypoxia (low oxygen levels). "Our study is the first to report that cumulative metformin use after cervical cancer diagnosis may be associated with decreased cervical cancer-specific and overall mortality among older women with diabetes," Dr Han and associates announce. "The potential of metformin to improve cervical cancer outcome deserves further interventional studies in depth."

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Diabetics gain longevity edge with drug therapy
What's Hot  

Type 2 diabetes is known to shorten life span, but recent research has revealed that a medication commonly used to treat it might enable diabetics to live longer on average than those without the disease.

Writing in the journal Diabetes, Obesity and Metabolism, Professor Craig Currie of Cardiff University and his colleagues report that treatment with metformin improved survival over follow-up in diabetics in comparison with those treated with sulphonylurea drugs, as well as in comparison with untreated nondiabetics.

"What we found was illuminating," Dr Currie stated. "Patients treated with metformin had a small but statistically significant improvement in survival compared with the cohort of nondiabetics, whereas those treated with sulphonylureas had a consistently reduced survival compared with nondiabetic patients. This was true even without any clever statistical manipulation."

The study included 78,241 diabetics treated with metformin and 12,222 prescribed sulphonylureas, matched with 90,463 nondiabetic control subjects. Nondiabetics experienced a 15% lower adjusted median survival time in comparison with diabetics treated with metformin. For those receiving sulphonylurea monotherapy, median survival time was 38% lower than metformin-treated patients.

"Surprisingly, the findings indicate that this cheap and widely prescribed diabetic drug may have beneficial effects not only on patients with diabetes but also for people without, and interestingly, people with type 1 diabetes," Dr Currie observed. "Metformin has been shown to have anticancer and anti-cardiovascular disease benefits. It can also reduce prediabetics' chances of developing the disease by a third."

"This does not mean that people with type 2 diabetes get off Scott free," he cautioned. "People lose on average around eight years from their life expectancy after developing diabetes. The best way to avoid the condition altogether is by keeping moderately lean and taking some regular light exercise."

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Life Extension Magazine® March 2016 Issue Now Online

Life Extension Magazine®

On the cover

New England Journal of Medicine exposes generic price scandal, by William Faloon


Safely reduce anxiety and mood disorders, by Stephen Harrington

Curcumin:  Aging brains and cancer, by Judy Stevens

Prevent gout attacks by lowering uric acid levels, by Michael Downey

Brain benefits of L-theanine, by Angela Sanford

Anti-aging human study on metformin wins FDA approval, by Judy Stevens

Pancreatic cancer clinical trial

What's behind the health care crisis? By Chase Falcon

Fungal infections and sinus problems, by Patrick Quillin, PhD, RD, CNS


In the News

Ask the doctor:  What causes gout? By Michael A. Smith, MD

Journal abstracts:  Theanine, uric acid, mood and sinus health

Read Now

Health Concern


Common symptoms of diabetes include increased thirst and urination, unusual weight changes, irritability, fatigue, and blurry vision. Clinical abnormalities include hyperglycemia and glucose in the urine. The breath might smell sweet because of ketones in the blood (ketosis), which are naturally sweet smelling. Dark outgrowths of skin (skin tags) may also appear.

The most common clinical tests used to diagnose diabetes are measures of blood glucose. The fasting plasma glucose (FPG) test measures the amount of glucose in the blood after fasting. Prediabetes is diagnosed if the fasting blood glucose level is between 100 and 125 mg/dL. Diabetes is diagnosed if the fasting blood glucose level rises to 126 mg/dL or above.

Metformin is now the most commonly prescribed oral antidiabetic drug worldwide. It works by increasing insulin sensitivity in the liver (Joshi 2005). It also has a number of other beneficial effects, including weight loss, reduced cholesterol-triglyceride levels, and improved endothelial function.

Metformin is effective on its own, but it may also be prescribed in combination with another class of insulin sensitizers called thiazolidinediones (TZDs; e.g., pioglitazone or Actos®, and rosiglitazone or Avandia®). TZDs increase insulin sensitivity and stimulate release of insulin from β-cells in the pancreas. TZD treatment also improves blood pressure and relieves vascular and lipid defects (Meriden 2004). However, TZDs have potentially serious side effects, including liver toxicity, which requires regular monitoring of liver function (Isley 2003; Marcy 2004).

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