Jiten Vora1, Kausik Ray2, Mikhail Kosiborod3, Neil R Poulter4, Sanjay Rajagopalan5, Lawrence A Leiter6. 1. Department of Diabetes and Endocrinology, Royal Liverpool University Hospitals, Prescot Street, Liverpool, L7 8XP, UK. Electronic address: Jitenvora@btinternet.com. 2. Department of Primary Care and Public Health, School of Public Health, Imperial College London, St. Dunstan's Road, London, W6 8RP, UK. Electronic address: k.ray@imperial.ac.uk. 3. Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, 4401 Wornall Road, Kansas City, MO 64111, USA. Electronic address: mkosiborod@cc-pc.com. 4. International Centre for Circulatory Health, Imperial College London, London, W2 1PG, UK. Electronic address: n.poulter@imperial.ac.uk. 5. University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD 21201, USA. Electronic address: srajagopalan@medicine.umaryland.edu. 6. Division of Endocrinology & Metabolism, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, 61 Queen St. East #6121, Toronto, ON, M5C 2T2, Canada. Electronic address: LeiterL@smh.ca.
Abstract
AIM: A clinical appraisal of existing scientific literature sought to assess the need for long-term prospective epidemiological studies to investigate an increased cancer risk of anti-hyperglycemic medication in type 2 diabetes. METHOD: A focus statement was formulated as: "With a higher risk of cancers in patients with type 2 diabetes, all anti-hyperglycemic drugs should undergo long-term, prospective epidemiological studies for cancer risks." Field surveys were sent to practicing physicians and endocrinologists to identify the currently prevalent level of acceptance of this statement. Subsequently, a meeting with a six-member panel of key opinion leaders was held to discuss published evidence in support and against the statement. This publication reviews the publications and discussion points brought forth in this meeting and their effect on statement acceptance by the panel. RESULTS: Whereas the majority of field survey responders primarily agreed with the statement, panel members were divided in their statement support. This division remained intact after review of the literature. CONCLUSIONS: While there was evidence that type 2 diabetes is associated with an increased risk of cancer, existing studies seemed insufficient to definitively demonstrate a link between cancer risk and use of specific anti-hyperglycemic therapies.
AIM: A clinical appraisal of existing scientific literature sought to assess the need for long-term prospective epidemiological studies to investigate an increased cancer risk of anti-hyperglycemic medication in type 2 diabetes. METHOD: A focus statement was formulated as: "With a higher risk of cancers in patients with type 2 diabetes, all anti-hyperglycemic drugs should undergo long-term, prospective epidemiological studies for cancer risks." Field surveys were sent to practicing physicians and endocrinologists to identify the currently prevalent level of acceptance of this statement. Subsequently, a meeting with a six-member panel of key opinion leaders was held to discuss published evidence in support and against the statement. This publication reviews the publications and discussion points brought forth in this meeting and their effect on statement acceptance by the panel. RESULTS: Whereas the majority of field survey responders primarily agreed with the statement, panel members were divided in their statement support. This division remained intact after review of the literature. CONCLUSIONS: While there was evidence that type 2 diabetes is associated with an increased risk of cancer, existing studies seemed insufficient to definitively demonstrate a link between cancer risk and use of specific anti-hyperglycemic therapies.