Richeek Pradhan1,2, Hui Yin2, Oriana H Y Yu2,3, Laurent Azoulay4,5,6. 1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada. 2. Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Cote Sainte-Catherine, H425.1, Montreal, H3T 1E2, Canada. 3. Division of Endocrinology, Jewish General Hospital, Montreal, Canada. 4. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada. laurent.azoulay@mcgill.ca. 5. Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Cote Sainte-Catherine, H425.1, Montreal, H3T 1E2, Canada. laurent.azoulay@mcgill.ca. 6. Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada. laurent.azoulay@mcgill.ca.
Abstract
INTRODUCTION: The association between long-acting insulin analogs and colorectal cancer is uncertain, with previous studies reporting discrepant findings. OBJECTIVE: To determine whether the use of long-acting insulin analogs is associated with an increased risk of colorectal cancer, when compared with use of intermediate-acting human insulins among patients with type 2 diabetes. METHODS: We conducted a population-based study using the United Kingdom Clinical Practice Research Datalink (CPRD). We identified patients newly treated with either a long-acting insulin analog or an intermediate-acting human insulin between September 1, 2002 and January 31, 2018, with follow-up until January 31, 2019. Each long-acting insulin analog user was propensity score-matched to one intermediate-acting human insulin user, and a lag of 1 year was imposed. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of colorectal cancer, comparing long-acting insulin analogs with intermediate-acting human insulin. Secondary analysis was conducted to assess whether there was a duration-response relationship. RESULTS: A total of 10,734 new long-acting insulin analog users were matched to 10,734 new intermediate-acting human insulin users. After a median follow-up of 2.8 years, the use of long-acting insulin analogs was not associated with an increased risk of colorectal cancer, compared with intermediate-acting human insulin (1.80 vs. 1.87 per 1000 person-years, respectively; HR 0.96, 95% CI 0.70-1.34). There was no evidence of a duration-response relationship. CONCLUSIONS: The results of this population-based study indicate that use of long-acting insulin analogs is not associated with an overall increased risk of colorectal cancer.
INTRODUCTION: The association between long-acting insulin analogs and colorectal cancer is uncertain, with previous studies reporting discrepant findings. OBJECTIVE: To determine whether the use of long-acting insulin analogs is associated with an increased risk of colorectal cancer, when compared with use of intermediate-acting human insulins among patients with type 2 diabetes. METHODS: We conducted a population-based study using the United Kingdom Clinical Practice Research Datalink (CPRD). We identified patients newly treated with either a long-acting insulin analog or an intermediate-acting humaninsulin between September 1, 2002 and January 31, 2018, with follow-up until January 31, 2019. Each long-acting insulin analog user was propensity score-matched to one intermediate-acting humaninsulin user, and a lag of 1 year was imposed. Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of colorectal cancer, comparing long-acting insulin analogs with intermediate-acting humaninsulin. Secondary analysis was conducted to assess whether there was a duration-response relationship. RESULTS: A total of 10,734 new long-acting insulin analog users were matched to 10,734 new intermediate-acting humaninsulin users. After a median follow-up of 2.8 years, the use of long-acting insulin analogs was not associated with an increased risk of colorectal cancer, compared with intermediate-acting humaninsulin (1.80 vs. 1.87 per 1000 person-years, respectively; HR 0.96, 95% CI 0.70-1.34). There was no evidence of a duration-response relationship. CONCLUSIONS: The results of this population-based study indicate that use of long-acting insulin analogs is not associated with an overall increased risk of colorectal cancer.
Authors: A J Varewijck; J A Goudzwaard; M P Brugts; S W J Lamberts; L J Hofland; J A M J L Janssen Journal: Growth Horm IGF Res Date: 2010-11-04 Impact factor: 2.372
Authors: Paul J H L Peeters; Marloes T Bazelier; Hubert G M Leufkens; Frank de Vries; Marie L De Bruin Journal: Diabetes Care Date: 2014-12-31 Impact factor: 19.112
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