Evaluating Metformin Strategies for Cancer Prevention: A Target Trial Emulation Using Electronic Health Records.

ABSTRACT:

Background

Metformin users appear to have a substantially lower risk of cancer than nonusers in many observational studies. These inverse associations may be explained by common flaws in observational analyses that can be avoided by explicitly emulating a target trial.

Methods

We emulated target trials of metformin therapy and cancer risk using population-based linked electronic health records from the UK (2009-2016). We included individuals with diabetes, no history of cancer, no recent prescription for metformin or other glucose-lowering medication, and hemoglobin A1c (HbA1c) <64 mmol/mol (<8.0%). Outcomes included total cancer and 4 site-specific cancers (breast, colorectal, lung, and prostate). We estimated risks using pooled logistic regression with adjustment for risk

SUBMITTER: Dickerman BA 

PROVIDER: S-EPMC10524586 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature