Volume 125, Issue 8 p. 1001-1008
Gynaecological Oncology

The role of metformin and statins in the incidence of epithelial ovarian cancer in type 2 diabetes: a cohort and nested case–control study

E Urpilainen

Corresponding Author

E Urpilainen

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

Correspondence: E Urpilainen, Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland. Email [email protected]Search for more papers by this author
M Marttila

M Marttila

Children, Adolescents and Families Unit, Department of Welfare, National Institute for Health and Welfare, Oulu, Finland

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A Hautakoski

A Hautakoski

Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland

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M Arffman

M Arffman

Service System Research Unit, National Institute for Health and Welfare, Helsinki, Finland

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R Sund

R Sund

Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland

Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

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P Ilanne-Parikka

P Ilanne-Parikka

The Diabetes Centre, Finnish Diabetes Association, Tampere, Finland

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R Arima

R Arima

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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J Kangaskokko

J Kangaskokko

Department of Pathology, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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U Puistola

U Puistola

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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E Läärä

E Läärä

Research Unit of Mathematical Sciences, University of Oulu, Oulu, Finland

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M Hinkula

M Hinkula

Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Medical Research Centre Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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First published: 07 February 2018
Citations: 18

Abstract

Objective

To obtain evidence of the effects of metformin and statins on the incidence of ovarian cancer in women with type 2 diabetes (T2D).

Design

A retrospective cohort study and nested case–control study.

Setting

The data were obtained from a diabetes database (FinDM) combining information from several nationwide registers.

Population

A cohort of 137 643 women over 40 years old and diagnosed with T2D during 1996–2011 in Finland.

Methods

In full cohort analysis Poisson regression was used to estimate the hazard ratios (HR) in relation to ever use of metformin, insulin other oral anti-diabetic medication or statins. In the nested case–control analysis 20 controls were matched to each case of ovarian cancer. Conditional logistic regression was used to estimate HRs in relation to medication use and cumulative use of different medications. The estimates were adjusted for age and duration of T2D.

Main outcome measure

Incidence of ovarian cancer.

Results

In all, 303 women were diagnosed with ovarian cancer during the follow up. Compared with other forms of oral anti-diabetic medication, metformin (HR 1.02, 95% CI: 0.72–1.45) was not found to be associated with the incidence of ovarian cancer. Neither was there evidence for statins to affect the incidence (HR 0.99, 95% CI: 0.78–1.25). In nested case–control analysis the results were essentially similar.

Conclusions

No evidence of an association between the use of metformin or statins and the incidence of ovarian cancer in women with T2D was found.

Tweetable abstract

No evidence found for metformin or statins reducing the incidence of ovarian cancer.