Evidence mapPaperPMID 41347173Full record

SynthesisFrontiers in pharmacology2025

Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis.

Mengdan Shen, Shan Lu, Zihao Xu, Feifei Zhou, Li-Ting Sheng, Qiang Yu

Abstract readSystematic Review
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mengdan Shen *Department of Gastroenterology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
Shan Lu *Department of Gastroenterology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
Zihao XuDepartment of Gastroenterology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
Feifei ZhouDepartment of Gastroenterology, Chengnan Street Community Health Service, Suzhou, Jiangsu, China.
Li-Ting Sheng *Phase I Clinical Trial Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.
Qiang Yu *Department of Gastroenterology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

adenomacancercolorectal neoplasmmetforminprimary prevention

Identifiers

PMID41347173
PMCPMC12672328

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.