Metformin × adverse events & safety

SynthesisJournal of the National Cancer Institute2024

Association of metformin use and cancer incidence: a systematic review and meta-analysis.

Lauren O'Connor et al.PubMed ↗Full text ↗Publisher ↗

  • Metformin uselooks good hereLower overall cancer, lower gastrointestinal cancer risk, lower urologic cancer risk.Correlation only, not a test of it.

What moved togetherboth groups pooled, not the treatment’s effect

Correlation, not cause

Metformin use went with lower overall cancer

−45%−70% to −20%

metformin use vs no metformin use, in case-control studies

Bigger than 8 in 10 for adverse events & safety

As reported

RR 0.55, 95% CI 0.30–0.80

Correlation, not cause

Metformin use went with lower overall cancer

−35%−63% to −7%

metformin use vs no metformin use, in prospective cohort studies

Bigger than 7 in 10 for adverse events & safety

As reported

RR 0.65, 95% CI 0.37–0.93

Correlation, not cause

Metformin use went with lower gastrointestinal cancer risk

−21%−27% to −15%

metformin use vs no metformin use

Bigger than 5 in 10 for adverse events & safety

As reported

RR 0.79, 95% CI 0.73–0.85

+2 more in the walkthrough ↓

Who was studied, and how

people with type 2 diabetes, in this paper

Already taking metformin use, or nottheir own situation, not assigned

on metformin use
not on metformin use

Metformin use went with lower overall cancer−45%

Metformin use went with lower gastrointestinal cancer risk−21%

Metformin use went with lower urologic cancer risk−12%

correlation, not a test

the abstract, start to end

observed in case-control studies (RR = 0.55, 95% confidence interval [CI] = 0.30 to 0.80) and prospective cohort studies (RR = 0.65, 95% CI = 0.37 to 0.93).

with reduced gastrointestinal (RR = 0.79, 95% CI = 0.73 to 0.85), urologic (RR = 0.88, 95% CI = 0.78 to 0.99), and hematologic (RR = 0.87, 95% CI = 0.75 to 0.99) cancer

← favours treatmentfavours comparator →
could be chance
Overall cancermetformin use vs no metformin use, in case-control studies
RR 0.550.30–0.80
Overall cancermetformin use vs no metformin use, in prospective cohort studies
RR 0.650.37–0.93
Gastrointestinal cancer riskmetformin use vs no metformin use
RR 0.790.73–0.85
Urologic cancer riskmetformin use vs no metformin use
RR 0.880.78–0.99
Hematologic cancer riskmetformin use vs no metformin use
RR 0.870.75–0.99
MetforminAdverse events & safety
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