Diabetes medication use and risk of breast, colorectal, and pancreatic cancer : a population-based cohort study
department or school: Medicine, Faculty of
department or school: Population and Public Health (SPPH), School of
data provider: DSpace
degree campus: UBCV
creator: Chen, Yixian
issued: 2023-08-04T00:06:30Z
issued: 2023
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: Certain diabetes medications have been linked to reduced risk of breast, colorectal, and pancreatic cancers, although findings are inconclusive, reflecting limitations in the methodology of previous studies. Objective: To evaluate associations between classes, subclasses and individual diabetes medications, and risks of breast, colorectal, and pancreatic cancers. Methods: Using linked administrative health data from the Province of British Columbia, a cohort of over 3 million people aged 35-100 (1996-2019) was constructed. Diabetes medication use was parameterized as binary, continuous, and categorical variables. Duration-response and dose-response associations were determined using cumulative duration and cumulative dose (years receiving the defined daily doses). Medication use was treated as time-varying, with a 1-year lag, over the follow-up period. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between new use of diabetes medications and occurrence of breast, colorectal, and pancreatic cancers. In a subset of participants from the British Columbia Generations Project (BCGP), risk estimates were further adjusted for sociodemographic and lifestyle variables. An active comparator analysis was employed to mitigate confounding by indication. Results: Metformin (HR=1.04, 95%CI=1.04-1.05) and insulin secretagogues (HR=1.02, 95%CI=1.01-1.02), especially gliclazide and glyburide, were found to be linked to an increased risk of colorectal cancer. A higher dose of basal insulin was associated with a higher pancreatic cancer risk (HR=1.05, 95%CI=1.04-1.06). Conversely, ever use of SGLT-2 inhibitors was related to a lower breast cancer risk than never use (HR=0.64, 95%CI=0.48-0.85). Many of these associations persisted after adjusting for sociodemographic and lifestyle factors in the BCGP subset. In the active comparator analysis, similar associations were identified when comp…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/85390
note: DIABETES MEDICATION USE AND RISK OF BREAST, COLORECTAL, AND PANCREATIC CANCER: A POPULATION-BASED COHORT STUDY by Yixian Chen BSc Hons, Brock University, 2017 MSc, Brock University, 2020 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Population and Public Health) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) August 2023 © Yixian Chen, 2023 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Diabetes medication use and risk of breast, colorectal, and pancreatic cancer: a population-based cohort study submitted by Yixian Chen in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Population and Public Health Examining Committee: Dr. Rachel Murphy, Assistant Professor, School of Population and Public Health, UBC Co-supervisor Dr. Trevor Dummer, Associate Professor, School of Population and Public Health, UBC Co-supervisor Dr. Parveen Bhatti, Associate Professor, School of Population and Public Health, UBC Supervisory Committee Member Dr. Kimberlyn McGrail, Professor, School of Population and Public Health, UBC University Examiner Dr. Tricia Tang, Associate Professor, Department of Medicine, UBC University Examiner iii Abstract Background: Certain diabetes medications have been linked to reduced risk of breast, colorectal, and pancreatic cancers, although findings are inconclusive, reflecting limitations in the methodology of previous studies. Objective: To evaluate associations between classes, subclasses and individual diabetes medications, and risks of breast, colorectal, and pancreatic cancers. Methods: Using linked administrative health data from the Province of British Columbia, a cohort of over 3 million people aged 35-100 (1996-2019) was constructed. Diabetes medication use was parameterized as binary, continuous, …
has type: Thesis/Dissertation
date issued: 2023-11
is shown at: 10.14288/1.0434668
language: eng
degree discipline: Population and Public Health
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Murphy, Rachel Anne
contributor: Dummer, Trevor J. B.
type: Text
identifier URI: http://hdl.handle.net/2429/85390