Metformin is associated with decreased risk of basal cell carcinoma: A whole-population case-control study from Iceland

© 2021 American Academy of Dermatology, Inc. 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 need...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology
Main Authors: Adalsteinsson, Jonas A., Muzumdar, Sonal, Waldman, Reid, Wu, Rong, Ratner, Désirée, Feng, Hao, Ungar, Jonathan, Silverberg, Jonathan I., Olafsdottir, Gudridur H., Kristjansson, Arni Kjalar, Tryggvadottir, Laufey, Jonasson, Jon Gunnlaugur
Format: Text
Language:unknown
Published: Health Sciences Research Commons 2021
Subjects:
basal cell carcinoma
keratinocyte carcinoma
metformin
squamous cell carcinoma
squamous cell carcinoma in situ
Iceland
Online Access:https://hsrc.himmelfarb.gwu.edu/smhs_derm_facpubs/535
https://doi.org/10.1016/j.jaad.2021.02.042
Description
Summary:© 2021 American Academy of Dermatology, Inc. 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.

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