Cancer risk among insulin users : comparing analogues with human insulin in the CARING five-country cohort study

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But , A , De Bruin , M L , Bazelier , M T , Hjellvik , V , Andersen , M , Auvinen , A , Starup-Linde , J , Schmidt , M K , Furu , K , de Vries , F , Karlstad , O , Ekstrom , N & Haukka , J 2017 , ' Cancer risk among insulin users : comparing analogues with human insulin in the CARING five-country cohort study ' , Diabetologia , vol. 60 , no. 9 , pp. 1691-1703 .

Title: Cancer risk among insulin users : comparing analogues with human insulin in the CARING five-country cohort study
Author: But, Anna; De Bruin, Marie L.; Bazelier, Marloes T.; Hjellvik, Vidar; Andersen, Morten; Auvinen, Anssi; Starup-Linde, Jakob; Schmidt, Marjanka K.; Furu, Kari; de Vries, Frank; Karlstad, Oystein; Ekstrom, Nils; Haukka, Jari
Contributor organization: Clinicum
University of Helsinki
Department of Public Health
Jari Haukka / Principal Investigator
Date: 2017-09
Language: eng
Number of pages: 13
Belongs to series: Diabetologia
ISSN: 0012-186X
Abstract: Aims/hypothesis The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. Methods National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112). By using a common data model and semi-aggregate approach, we pooled individual-level records from five cohorts and applied Poisson regression models. For each of ten cancer sites studied, we estimated the rate ratios (RRs) by duration (6 years) of cumulative exposure to insulin glargine or insulin detemir relative to that of human insulin. Results A total of 21,390 cancer cases occurred during a mean follow-up of 4.6 years. No trend with cumulative treatment time for insulin glargine relative to human insulin was observed in risk for any of the ten studied cancer types. Of the 136 associations tested in the main analysis, only a few increased and decreased risks were found: among women, a higher risk was observed for colorectal (RR 1.54, 95% CI 1.06, 2.25) and endometrial cancer (RR 1.78, 95% CI 1.07, 2.94) for 6 years (RR 0.22, 95% CI 0.05, 0.92). Comparisons of insulin detemir with human insulin also showed no consistent differences. Conclusions/interpretation The present multi-country study found no evidence of consistent differences in risk for ten cancers for insulin glargine or insulin detemir use compared with human insulin, at follow-up exceeding 5 years.
Subject: Cancer risk
Cohort study
Common datamodel
Cumulative treatment time
Human insulin
Rate ratio
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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