SynthesisFrontiers in pharmacology2025
Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis.
Synthesis in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Metformin shows promise in preventing colorectal cancer (CRC) and its precursors, but evidence on its dose-response effect remains limited. Aim: To determine the association between metformin therapy and colorectal neoplasms in adenoma-free individuals and characterize the dose-response relationship. Methods: Adjusted effect estimates from each study were aggregated using a random-effect model. Subgroup analyses, publication bias assessment, sensitivity analyses and dose-response analyses were conducted. Results: A total of 37 eligible studies, involving 1,416,085 participants, were included. Metformin significantly reduced colorectal neoplasms risk (Hazard ratio (HR) = 0.79, 95% confidence interval (CI), 0.73-0.85, Odds ratio (OR) = 0.80, 95% confidence interval, 0.74-0.87). Subgroup analyses demonstrated enhanced efficacy in Asian populations, younger patients (<60 years), and cohorts with ≥50% male participants. Dose-response analysis identified 331 mg/day as the optimal dose for CRC risk reduction (OR = 0.83, 95% CI, 0.76-0.91). Each additional year of use reduced CRC risk by 3% (OR = 0.97, 95% CI, 0.95-0.99). Conclusion: Metformin demonstrates effective chemoprevention against colorectal neoplasms, where the inverse association was most prominent at low-dose, long-term therapy. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, Identifier CRD42023394042.
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