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The effect of metformin on esophageal cancer risk in patients with type 2 diabetes mellitus: a systematic review and meta‑analysis

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Abstract

Objective

Recently, numerous studies have yielded inconsistent results regarding the effect of metformin on esophageal cancer risk in type 2 diabetes mellitus patients. The purpose of this study is to systematically assess this effect using meta-analysis.

Methods

We searched clinical studies on metformin and esophageal cancer risk in PubMed, Embase, and the Cochrane Library. After literature screening, a series of meta-analyses were conducted using RevMan 5.3 software. The pooled hazard ratio (HR) and the corresponding 95% confidence interval (CI) were used as the effect size.

Results

Five eligible studies (four cohort studies and one case–control study) were included for our meta-analysis using a random-effect model. The analysis showed that metformin could not reduce esophageal cancer risk in type 2 diabetes mellitus patients (HR 0.88, 95% CI 0.60–1.28, P > 0.05). Subgroup analyses by geographic location showed that metformin significantly reduced esophageal cancer risk in Asian patients with type 2 diabetes mellitus (HR 0.59, 95% CI 0.39–0.91, P = 0.02), without heterogeneity between studies (P = 0.80 and I2 = 0%).

Conclusions

Overall, our systematic review and meta-analysis demonstrate that metformin does not reduce esophageal cancer risk in type 2 diabetes mellitus patients. However, a significant reduction in esophageal cancer risk in Asian populations remains to be clarified.

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Acknowledgements

The authors are grateful to Yanhua Song for proofreading this manuscript.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Second Hospital of Hebei Medical University, Heping Western Road No.215, Shijiazhuang, 050000, Hebei, China

    H.-D. Wu & B.-J. Zhou

  2. Department of General Practice, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China

    J.-J. Zhang

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  1. H.-D. Wu
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Correspondence to B.-J. Zhou.

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Wu, HD., Zhang, JJ. & Zhou, BJ. The effect of metformin on esophageal cancer risk in patients with type 2 diabetes mellitus: a systematic review and meta‑analysis. Clin Transl Oncol 23, 275–282 (2021). https://doi.org/10.1007/s12094-020-02415-6

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