Original Contribution | Published:

Pancreas and Biliary Tract

Use of Antidiabetic Agents and the Risk of Pancreatic Cancer: A Case–Control Analysis

The American Journal of Gastroenterology volume 107, pages 620626 (2012) | Download Citation



The objective of this study was to explore the association between use of metformin or other antidiabetic drugs, diabetes, and the risk of pancreatic cancer.


We conducted a case–control study using the UK-based General Practice Research Database (GPRD). Cases had a first-time diagnosis of pancreatic cancer, and six controls per case were matched on age, sex, calendar time, general practice, and number of years of active history in the GPRD before the index date. Results were further adjusted in multivariate logistic regression analyses for potential confounders such as body mass index, smoking, alcohol consumption, and diabetes duration.


In all, 2,763 case patients with a recorded diagnosis of pancreatic cancer were identified. Mean age±s.d. was 69.5±11.0 years. Long-term use (≥30 prescriptions) of metformin was not associated with a materially altered risk of pancreatic cancer (adjusted odds ratio (adj. OR): 0.87, 95% confidence interval (CI): 0.59–1.29), but there was a suggestion of effect modification by gender, as long-term use of metformin was linked to a decreased risk in women (adj. OR: 0.43, 95% CI: 0.23–0.80). Both use of sulfonylureas (≥30 prescriptions, adj. OR: 1.90, 95% CI: 1.32–2.74) and of insulin (≥40 prescriptions, adj. OR: 2.29, 95% CI: 1.34–3.92) were associated with an increased risk of pancreatic cancer.


Use of metformin was associated with a decreased risk of pancreatic cancer in women only, whereas use of sulfonylureas and of insulin was associated with an increased risk of pancreatic cancer.

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  1. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland

    • Michael Bodmer
    • , Claudia Becker
    •  & Christoph R Meier
  2. Emergency Department, University Hospital Basel, Basel, Switzerland

    • Michael Bodmer
  3. Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Basel, Switzerland

    • Christian Meier
  4. Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts, USA

    • Susan S Jick
    •  & Christoph R Meier
  5. Hospital Pharmacy, University Hospital Basel, Basel, Switzerland

    • Christoph R Meier


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Competing interests

Guarantor of the article: Christoph R. Meier.

Specific author contributions: Concept and design, acquisition of data, and drafting of the manuscript: Christoph R. Meier and Michael Bodmer; analysis and interpretation of data: Claudia Becker, Christoph R. Meier, Michael Bodmer, Susan S. Jick, and Christian Meier; critical revision of the manuscript for important intellectual content: Michael Bodmer, Christoph R. Meier, Christian Meier, Susan S. Jick, and Claudia Becker; statistical analysis/expertise: Claudia Becker and Christoph R. Meier; administrative, technical, or material support: NA.

Financial support: This work was partially funded by the Swiss Cancer League (Krebsliga Schweiz) and the Research Fund of the University of Basel, Switzerland but the work was independently done by the authors.

Potential competing interests: None.

Corresponding author

Correspondence to Christoph R Meier.

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