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Association of metformin use with ovarian cancer incidence and prognosis: a systematic review and meta-analysis
  1. Jinghua Shi1,
  2. Baoli Liu2,
  3. Hongmei Wang3,
  4. Tie Zhang3 and
  5. Libo Yang3
  1. 1 Department of Information, Taian City Central Hospital, Taian, People’s Republic of China
  2. 2 Taian City Central Hospital, Taian, People’s Republic of China
  3. 3 Department of Endocrinology, Taian City Central Hospital, Taian, People’s Republic of China
  1. Correspondence to Libo Yang, Department of Endocrinology, Taian City Central Hospital, Taian 271000, People’s Republic of China; yanglibo80119{at}


Background Some clinical and basic research studies have indicated that exposure to metformin might have protective effects against ovarian cancer. However, results from epidemiologic studies have been inconsistent. We performed a meta-analysis to evaluate the effect of metformin use on the risk of ovarian cancer occurrence and mortality.

Methods Multiple databases were searched to identify studies on the association between use of metformin and risk of ovarian cancer or prognosis, up to August 2018. Relevant information for analysis was extracted. A random-effects model was used to calculate the pooled risk estimate.

Results Thirteen articles were included, of which six articles focused on ovarian cancer incidence and the others focused on prognosis. The pooled OR for ovarian cancer occurrence and mortality comparing metformin use with non-use or use of other hypoglycemic drugs was 0.76 (95% CI 0.62 to 0.93, p = 0.008) and 0.55 (95% CI 0.36 to 0.84, p = 0.006), respectively. Moderate to substantial heterogeneity was observed across included studies.

Conclusions Our findings demonstrate that use of metformin was significantly associated with a lower incidence and a better prognosis of ovarian cancer in patients with diabetes. Well-designed interventional studies are warranted to confirm our findings.

  • metformin
  • ovarian neoplasms
  • prognosis
  • meta-analysis

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  • Funding This research was supported by grants from Technology Development Project of Taian City of China (2017NS0177).

  • Competing interests None declared.

  • Ethics approval This study was approved by the authors' institutional ethics committee.

  • Provenance and peer review Not commissioned, externally peer reviewed.