These authors contributed equally to this work.
Article first published online: 19 APR 2012
Copyright © 2011 American Association for the Study of Liver Diseases
Volume 55, Issue 5, pages 1462–1472, May 2012
How to Cite
Chang, C.-H., Lin, J.-W., Wu, L.-C., Lai, M.-S., Chuang, L.-M. and Arnold Chan, K. (2012), Association of thiazolidinediones with liver cancer and colorectal cancer in type 2 diabetes mellitus. Hepatology, 55: 1462–1472. doi: 10.1002/hep.25509
Potential conflict of interest: Nothing to report.
Supported in part by Taiwan Department of Health grant DOH098-TD-D-113-098016, which did not play any role in our study design, collection, analysis, and interpretation of data, in report writing, or in the decision to submit the article for publication. The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the Department of Health, Executive Yuan, Taiwan.
- Issue published online: 19 APR 2012
- Article first published online: 19 APR 2012
- Accepted manuscript online: 2 DEC 2011 01:20AM EST
- Manuscript Accepted: 17 NOV 2011
- Manuscript Received: 8 JUN 2011
The objective of this nationwide case-control study was to evaluate the risk of specific malignancy in diabetic patients who received thiazolidinediones (TZDs). A total of 606,583 type 2 diabetic patients, age 30 years and above, without a history of cancer were identified from the Taiwan National Health Insurance claims database during the period between January 1 2000 and December 31 2000. As of December 31 2007, patients with incident cancer of liver, colorectal, lung, and urinary bladder were included as cases and up to four age- and sex-matched controls were selected by risk-set sampling. Logistic regression models were applied to estimate the odds ratio (OR) and 95% confidence interval (CI) between TZDs and cancer incidence. A total of 10,741 liver cancer cases, 7,200 colorectal cancer cases, and 70,559 diabetic controls were included. A significantly lower risk of liver cancer incidence was found for any use of rosiglitazone (OR: 0.73, 95% CI: 0.65-0.81) or pioglitazone (OR: 0.83, 95% CI: 0.72-0.95), respectively. The protective effects were stronger for higher cumulative dosage and longer duration. For colorectal cancer, rosiglitazone, but not pioglitazone, was associated with a significantly reduced risk (OR: 0.86; 95% CI: 0.76-0.96). TZDs were not associated with lung and bladder cancer incidence, although a potential increased risk for bladder cancer with pioglitazone use ≥3 years could not be excluded (OR: 1.56; 95% CI: 0.51-4.74). Conclusion: The use of pioglitazone and rosiglitazone is associated with a decreased liver cancer incidence in diabetic patients. The effects on occurrence of specific cancer types may be different for pioglitazone and rosiglitazone. (HEPATOLOGY 2012;)