University of Mississippi Medical Center Jackson, MS
Himmat Brar, MD1, Syeda Ilsa Aaqil, 2, Muhammad Rehman, 2, Dayab Asad, 2, Arsalan Zafar Iqbal, 3, Yousaf Zafar, MD1 1University of Mississippi Medical Center, Jackson, MS; 2Jinnah Sindh Medical University, Karachi, Sindh, Pakistan; 3University of Mississippi Medical Center, Karachi, Sindh, Pakistan
Introduction: Metformin use in diabetic patients has been associated with a potential decrease in colorectal cancer (CRC) risk, and improved prognosis but the evidence is inconclusive. Therefore, we aimed to pool all studies evaluating the impact of metformin usage on CRC risk and survival outcomes in individuals with diabetes mellitus (DM).
Methods: PubMed was queried from inception until 8 May 2023 for studies that compared the effects of metformin versus no-metformin usage in patients with CRC and DM. The outcomes examined included the risk of CRC incidence, all-cause mortality, and CRC-specific mortality in DM. A random-effects model was used, and the results were reported as Odds Ratios (OR) or Hazard Ratios (HR) with corresponding 95% confidence intervals (CI).
Results: In our meta-analysis of fourty-two studies(n= 2163047), metformin treatment was associated with a significant reduction in the risk of CRC (OR = 0.72, 95% CI 0.64-0.80, p < 0.00001) and all-cause mortality in patients with DM (HR = 0.61, 95% CI 0.46-0.80, p = 0.0004). Metformin also showed a decreased risk of CRC-specific mortality (HR = 0.76, 95% CI 0.67-0.86, p < 0.00001). Subgroup analysis indicated that both pre-diagnostic (HR= 0.76, 95% CI 0.67-0.86, p< 0.0001) and post-diagnostic (HR=0.75, 95% CI 0.56-1.01, p=0.06) use of metformin reduced the risk of CRC-specific mortality similarly; p-interaction= 0.91.
Discussion: Our meta-analysis demonstrates that the use of metformin reduces the risk of CRC, CRC-specific mortality, and all-cause mortality. These results underscore the significant potential of metformin as an effective treatment option for managing CRC in individuals with DM.
Figure: Figure 1a). Effect of metformin usage on risk of CRC incidence in DM. Figure 1b). Effect of metformin usage on all-cause mortality of CRC in DM. Figure 1c). Effect of metformin usage on CRC-specific mortality in DM.
Disclosures:
Himmat Brar indicated no relevant financial relationships.
Syeda Ilsa Aaqil indicated no relevant financial relationships.
Muhammad Rehman indicated no relevant financial relationships.
Dayab Asad indicated no relevant financial relationships.
Arsalan Zafar Iqbal indicated no relevant financial relationships.
Yousaf Zafar indicated no relevant financial relationships.
Himmat Brar, MD1, Syeda Ilsa Aaqil, 2, Muhammad Rehman, 2, Dayab Asad, 2, Arsalan Zafar Iqbal, 3, Yousaf Zafar, MD1. P3047 - The Impact of Metformin Usage on Colorectal Cancer and Prognosis in Individuals with Diabetes Mellitus: A Systematic Review and Meta Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
