TY - JOUR
T1 - Metformin is associated with decreased risk of basal cell carcinoma
T2 - A whole-population case-control study from Iceland
AU - Adalsteinsson, Jonas A.
AU - Muzumdar, Sonal
AU - Waldman, Reid
AU - Wu, Rong
AU - Ratner, Désirée
AU - Feng, Hao
AU - Ungar, Jonathan
AU - Silverberg, Jonathan I.
AU - Olafsdottir, Gudridur H.
AU - Kristjansson, Arni Kjalar
AU - Tryggvadottir, Laufey
AU - Jonasson, Jon Gunnlaugur
N1 - Funding Information:
Funding sources: None.
Publisher Copyright:
© 2021 American Academy of Dermatology, Inc.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Metformin has anticarcinogenic properties and is also known to inhibit the sonic hedgehog pathway, but population-based studies analyzing the potential protective effect for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are needed. Objectives: To delineate the association between metformin use and invasive SCC, SCC in situ (SCCis), and BCC. Methods: A population-based case-control study design was employed using all 6880 patients diagnosed in Iceland between 2003-2017 with first-time BCC, SCCis, or invasive SCC, and 69,620 population controls. Multivariate odds ratios (ORs) were calculated using conditional logistic regression. Results: Metformin was associated with a lower risk of developing BCC (OR, 0.71; 95% confidence interval [CI], 0.61-0.83), even at low doses. No increased risk of developing SCC was observed. SCCis risk was mildly elevated in the 501-1500 daily dose unit category (OR, 1.40; 95% CI, 1.00-1.96). Limitations: This study was retrospective in nature with the inability to adjust for ultraviolet exposure, Fitzpatrick skin type, and comorbidities. Conclusion: Metformin is associated with decreased risk of BCC development, even at low doses. Metformin might have potential as a chemoprotective agent for patients at high risk of BCC, although this will need confirmation in future studies.
AB - Background: Metformin has anticarcinogenic properties and is also known to inhibit the sonic hedgehog pathway, but population-based studies analyzing the potential protective effect for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are needed. Objectives: To delineate the association between metformin use and invasive SCC, SCC in situ (SCCis), and BCC. Methods: A population-based case-control study design was employed using all 6880 patients diagnosed in Iceland between 2003-2017 with first-time BCC, SCCis, or invasive SCC, and 69,620 population controls. Multivariate odds ratios (ORs) were calculated using conditional logistic regression. Results: Metformin was associated with a lower risk of developing BCC (OR, 0.71; 95% confidence interval [CI], 0.61-0.83), even at low doses. No increased risk of developing SCC was observed. SCCis risk was mildly elevated in the 501-1500 daily dose unit category (OR, 1.40; 95% CI, 1.00-1.96). Limitations: This study was retrospective in nature with the inability to adjust for ultraviolet exposure, Fitzpatrick skin type, and comorbidities. Conclusion: Metformin is associated with decreased risk of BCC development, even at low doses. Metformin might have potential as a chemoprotective agent for patients at high risk of BCC, although this will need confirmation in future studies.
KW - basal cell carcinoma
KW - keratinocyte carcinoma
KW - metformin
KW - squamous cell carcinoma
KW - squamous cell carcinoma in situ
UR - http://www.scopus.com/inward/record.url?scp=85103085610&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2021.02.042
DO - 10.1016/j.jaad.2021.02.042
M3 - Article
C2 - 33610593
AN - SCOPUS:85103085610
SN - 0190-9622
VL - 85
SP - 56
EP - 61
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 1
ER -