Yao-Hsien Tseng1, Yu-Tse Tsan2, Wei-Cheng Chan3, Wayne Huey-Herng Sheu4, Pau-Chung Chen5. 1. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Division of Geriatrics, Puli Branch, Taichung Veterans General Hospital, Puli, Taiwan. 2. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 3. Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Defense Medical Center, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Medical Technology, National Chung Hsing University, Taichung, Taiwan whhsheu@vghtc.gov.tw. 5. Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan pchen@ntu.edu.tw.
Abstract
OBJECTIVE: Acarbose, an α-glucosidase inhibitor, has been shown to have antineoplastic effects on colorectal cancer in biomarker studies. We assessed the association between acarbose use in patients with diabetes and incident colorectal cancer. RESEARCH DESIGN AND METHODS: We conducted a nationwide, population-based study using a large cohort with diabetes in the Taiwan National Health Insurance Research Database. Patients with newly diagnosed diabetes (n = 1,343,484) were enrolled between 1998 and 2010. One control subject not using acarbose was randomly selected for each subject using acarbose after matching for age, sex, diabetes onset, and comorbidities. Cox proportional hazards regression with a competing risks analysis was used to calculate the hazard ratios (HRs) and 95% CIs for the association between acarbose use and incident colorectal cancer for each eligible case-control pair (n = 199,296). RESULTS: There were 1,332 incident cases of colorectal cancer in the cohort with diabetes during the follow-up period of 1,487,136 person-years. The overall incidence rate was 89.6 cases per 100,000 person-years. Patients treated with acarbose had a 27% reduction in the risk of colorectal cancer compared with control subjects. The adjusted HRs were 0.73 (95% CI 0.63-0.83), 0.69 (0.59-0.82), and 0.46 (0.37-0.58) for patients using >0 to <90, 90 to 364, and ≥365 cumulative defined daily doses of acarbose, respectively, compared with subjects who did not use acarbose (P for trend < 0.001). CONCLUSIONS: Acarbose use reduced the risk of incident colorectal cancer in patients with diabetes in a dose-dependent manner.
OBJECTIVE:Acarbose, an α-glucosidase inhibitor, has been shown to have antineoplastic effects on colorectal cancer in biomarker studies. We assessed the association between acarbose use in patients with diabetes and incident colorectal cancer. RESEARCH DESIGN AND METHODS: We conducted a nationwide, population-based study using a large cohort with diabetes in the Taiwan National Health Insurance Research Database. Patients with newly diagnosed diabetes (n = 1,343,484) were enrolled between 1998 and 2010. One control subject not using acarbose was randomly selected for each subject using acarbose after matching for age, sex, diabetes onset, and comorbidities. Cox proportional hazards regression with a competing risks analysis was used to calculate the hazard ratios (HRs) and 95% CIs for the association between acarbose use and incident colorectal cancer for each eligible case-control pair (n = 199,296). RESULTS: There were 1,332 incident cases of colorectal cancer in the cohort with diabetes during the follow-up period of 1,487,136 person-years. The overall incidence rate was 89.6 cases per 100,000 person-years. Patients treated with acarbose had a 27% reduction in the risk of colorectal cancer compared with control subjects. The adjusted HRs were 0.73 (95% CI 0.63-0.83), 0.69 (0.59-0.82), and 0.46 (0.37-0.58) for patients using >0 to <90, 90 to 364, and ≥365 cumulative defined daily doses of acarbose, respectively, compared with subjects who did not use acarbose (P for trend < 0.001). CONCLUSIONS:Acarbose use reduced the risk of incident colorectal cancer in patients with diabetes in a dose-dependent manner.
Authors: Nieves González; Isabel Prieto; Laura Del Puerto-Nevado; Sergio Portal-Nuñez; Juan Antonio Ardura; Marta Corton; Beatriz Fernández-Fernández; Oscar Aguilera; Carmen Gomez-Guerrero; Sebastián Mas; Juan Antonio Moreno; Marta Ruiz-Ortega; Ana Belen Sanz; Maria Dolores Sanchez-Niño; Federico Rojo; Fernando Vivanco; Pedro Esbrit; Carmen Ayuso; Gloria Alvarez-Llamas; Jesús Egido; Jesús García-Foncillas; Alberto Ortiz Journal: Oncotarget Date: 2017-03-14