Metformin and other anti-diabetic medication use and breast cancer incidence in the Nurses' Health Studies.

Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0042124 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0215 (Electronic) Linking ISSN: 00207136 NLM ISO Abbreviation: Int J Cancer Subsets: MEDLINE

Publication: 1995- : New York, NY : Wiley-Liss
Original Publication: 1966-1984 : Genève : International Union Against Cancer

Metformin*/therapeutic use ; Breast Neoplasms*/epidemiology ; Breast Neoplasms*/drug therapy ; Hypoglycemic Agents*/therapeutic use ; Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/epidemiology; Humans ; Female ; Incidence ; Middle Aged ; Adult ; Prospective Studies ; United States/epidemiology ; Risk Factors ; Nurses/statistics & numerical data ; Proportional Hazards Models

We aimed to examine the association between the use of metformin and other anti-diabetic medications and breast cancer incidence within two large prospective cohort studies. We followed 185,181 women who participated in the Nurses' Health Study (NHS; 1994-2016) and the NHSII (1995-2017), with baseline corresponding to the date metformin was approved for type 2 diabetes (T2D) treatment in the US Information on T2D diagnosis, anti-diabetes medications, and other covariates was self-reported at baseline and repeatedly assessed by follow-up questionnaires every 2 years. Breast cancer cases were self-reported and confirmed by medical record review. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between medication use and breast cancer were estimated using Cox proportional hazards regression models, adjusting for breast cancer risk factors. During 3,324,881 person-years of follow-up, we ascertained 9,192 incident invasive breast cancer cases, of which 451 were among women with T2D. Compared with women without T2D (n = 169,263), neither metformin use (HR = 0.97; 95% CI = 0.81-1.15) nor other anti-diabetic medications use (HR = 1.11; 95% CI = 0.90-1.36) associated with significantly lower breast cancer incidence. Among women with T2D (n = 15,918), compared with metformin never users, metformin ever use was not significantly inversely associated with breast cancer (HR = 0.92; 95% CI = 0.74-1.15). Although we observed that past use of metformin was inversely associated with breast cancer in the T2D population (HR = 0.67; 95% CI = 0.48-0.94), current use (HR = 1.01; 95% CI = 0.80-1.27) and longer duration of metformin use were not associated with breast cancer (each 2-year interval: HR = 1.01; 95% CI = 0.95-1.07). Overall, metformin use was not associated with the risk of developing breast cancer among the overall cohort population or among women with T2D.
(© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

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R01 CA050385 United States CA NCI NIH HHS; R01 ES028033 United States ES NIEHS NIH HHS; P01 CA087969 United States CA NCI NIH HHS; R00 CA267557 United States CA NCI NIH HHS; UM1 CA186107 United States CA NCI NIH HHS; T32 CA009001 United States CA NCI NIH HHS; UM1CA186107 United States CA NCI NIH HHS; U01CA176726 United States CA NCI NIH HHS; P01CA87969 United States CA NCI NIH HHS; K99 CA267557 United States CA NCI NIH HHS; R01CA050385 United States CA NCI NIH HHS; R01ES028033 United States ES NIEHS NIH HHS; R00CA267557 United States CA NCI NIH HHS; K99CA267557 United States CA NCI NIH HHS; U01 CA176726 United States CA NCI NIH HHS; Breast Cancer Research Foundation; T32CA009001 United States CA NCI NIH HHS

Keywords: breast cancer; diabetes mellitus; metformin

Date Created: 20240323 Date Completed: 20240515 Latest Revision: 20240517

20240517

PMC11096056

10.1002/ijc.34917

38520039