Human insulin does not increase bladder cancer risk.

BACKGROUND: Whether human insulin can induce bladder cancer is rarely studied. METHODS: The reimbursement databases of all Taiwanese diabetic patients from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2004 and a total of 785,234 patients with typ...

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Main Author: Chin-Hsiao Tseng
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3896459?pdf=render
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author Chin-Hsiao Tseng
author_facet Chin-Hsiao Tseng
author_sort Chin-Hsiao Tseng
collection DOAJ
description BACKGROUND: Whether human insulin can induce bladder cancer is rarely studied. METHODS: The reimbursement databases of all Taiwanese diabetic patients from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2004 and a total of 785,234 patients with type 2 diabetes were followed up for bladder cancer incidence until the end of 2009. Users of pioglitazone were excluded and the period since the initiation of insulin glargine (marketed after the entry date in Taiwan) was not included in the calculation of follow-up. Incidences for ever-users, never-users and subgroups of human insulin exposure (using tertile cutoffs of time since starting insulin, duration of therapy and cumulative dose) were calculated and the hazard ratios were estimated by Cox regression. RESULTS: There were 87,940 ever-users and 697,294 never-users, with respective numbers of incident bladder cancer of 454 (0.52%) and 3,330 (0.48%), and respective incidence of 120.49 and 94.74 per 100,000 person-years. The overall hazard ratios (95% confidence intervals) indicated a significant association with insulin in the age-sex-adjusted models [1.238 (1.122-1.366)], but not in the model adjusted for all covariates [1.063 (0.951-1.187)]. There was also a significant trend for the hazard ratios for the different categories of the dose-response parameters in the age-sex-adjusted models, which became insignificant when all covariates were adjusted. CONCLUSIONS: This study relieves the concern of a bladder cancer risk associated with human insulin. Appropriate adjustment for confounders is important in the evaluation of cancer risk associated with a medication.
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spelling doaj.art-e24a1de6fcce449fbb4db13a02fd92852022-12-21T21:59:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0191e8651710.1371/journal.pone.0086517Human insulin does not increase bladder cancer risk.Chin-Hsiao TsengBACKGROUND: Whether human insulin can induce bladder cancer is rarely studied. METHODS: The reimbursement databases of all Taiwanese diabetic patients from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2004 and a total of 785,234 patients with type 2 diabetes were followed up for bladder cancer incidence until the end of 2009. Users of pioglitazone were excluded and the period since the initiation of insulin glargine (marketed after the entry date in Taiwan) was not included in the calculation of follow-up. Incidences for ever-users, never-users and subgroups of human insulin exposure (using tertile cutoffs of time since starting insulin, duration of therapy and cumulative dose) were calculated and the hazard ratios were estimated by Cox regression. RESULTS: There were 87,940 ever-users and 697,294 never-users, with respective numbers of incident bladder cancer of 454 (0.52%) and 3,330 (0.48%), and respective incidence of 120.49 and 94.74 per 100,000 person-years. The overall hazard ratios (95% confidence intervals) indicated a significant association with insulin in the age-sex-adjusted models [1.238 (1.122-1.366)], but not in the model adjusted for all covariates [1.063 (0.951-1.187)]. There was also a significant trend for the hazard ratios for the different categories of the dose-response parameters in the age-sex-adjusted models, which became insignificant when all covariates were adjusted. CONCLUSIONS: This study relieves the concern of a bladder cancer risk associated with human insulin. Appropriate adjustment for confounders is important in the evaluation of cancer risk associated with a medication.http://europepmc.org/articles/PMC3896459?pdf=render
spellingShingle Chin-Hsiao Tseng
Human insulin does not increase bladder cancer risk.
PLoS ONE
title Human insulin does not increase bladder cancer risk.
title_full Human insulin does not increase bladder cancer risk.
title_fullStr Human insulin does not increase bladder cancer risk.
title_full_unstemmed Human insulin does not increase bladder cancer risk.
title_short Human insulin does not increase bladder cancer risk.
title_sort human insulin does not increase bladder cancer risk
url http://europepmc.org/articles/PMC3896459?pdf=render
work_keys_str_mv AT chinhsiaotseng humaninsulindoesnotincreasebladdercancerrisk