Metformin Use and Gastric Cancer Risk in Diabetic Patients
Summary
Metformin, a first‐line pharmacotherapy for type 2 diabetes mellitus, has gained attention for its potential role beyond glycaemic control, notably in cancer prevention. Gastric cancer remains a major global health burden, with incidence highest in East Asia but rising in many regions. Diabetic patients exhibit metabolic alterations—hyperinsulinaemia, insulin resistance, chronic inflammation—that may promote gastric carcinogenesis. Preclinical studies indicate that metformin activates AMP-activated protein kinase, inhibits mTOR signalling and modulates inflammatory pathways, potentially reducing malignant transformation in gastric mucosa. Epidemiological investigations have sought to quantify the association between metformin exposure and gastric cancer incidence or mortality. Overall, emerging evidence suggests that long-term metformin use is associated with a modest reduction in gastric cancer risk among patients with type 2 diabetes, although heterogeneity in study design and population characteristics calls for cautious interpretation. Understanding the molecular mechanisms and identifying patient subgroups most likely to benefit remain priorities for translating these observations into clinical practice.
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Metformin Use and Gastric Cancer Risk in Diabetic Patients publication trend
The graph below shows the total number of articles in metformin use and gastric cancer risk in diabetic patients across all publications each year (not limited to Nature Index journals).
Technical terms
Metformin: A biguanide antidiabetic agent that lowers blood glucose by suppressing hepatic gluconeogenesis and enhancing insulin sensitivity, also noted for antiproliferative effects in cancer models.
Gastric intestinal metaplasia: A precancerous condition in which gastric epithelial cells are replaced by intestinal‐type epithelium, increasing the risk of gastric adenocarcinoma.
Meta-analysis: A quantitative method that combines results from multiple independent studies to derive a summary estimate of an intervention’s effect size or association.
Hazard ratio: A relative measure of the instantaneous risk of an event occurring in one group compared to another over a defined period, commonly used in survival analysis.
References
- Diabetes and gastric cancer incidence and mortality in the Asia Cohort Consortium: A pooled analysis of more than a half million participants. Journal of Diabetes (2024).
- Revealing the role of metformin in gastric intestinal metaplasia treatment. Frontiers in Pharmacology (2024).
- Association between metformin and the risk of gastric cancer in patients with type 2 diabetes mellitus: a meta-analysis of cohort studies. Oncotarget (2017).
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