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Anti-diabetic treatment and cancer occurrence among patients with type II diabetes mellitus

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TitleInfo
Title
Anti-diabetic treatment and cancer occurrence among patients with type II diabetes mellitus
Name (type = personal)
NamePart (type = family)
Qiu
NamePart (type = given)
Hong
NamePart (type = date)
1968-
DisplayForm
Hong Qiu
Role
RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
RHOADS
NamePart (type = given)
GEORGE
DisplayForm
GEORGE RHOADS
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
chair
Name (type = personal)
NamePart (type = family)
Marcella
NamePart (type = given)
Stephen W
DisplayForm
Stephen W Marcella
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
DEMISSIE
NamePart (type = given)
KITAW
DisplayForm
KITAW DEMISSIE
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Berlin
NamePart (type = given)
Jesse
DisplayForm
Jesse Berlin
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School - New Brunswick
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2011
DateOther (qualifier = exact); (type = degree)
2011-10
CopyrightDate (qualifier = exact)
2011
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
This is a retrospective cohort study, with nested case-control analyses, of type II diabetes patients, to evaluate the association between anti-diabetic treatment and cancer incidence. Methods: Patients who were initially stabilized on an oral hypoglycemic agent (OHA) mono-therapy, including metformin, sulfonylurea, TZD, and meglitinides, in the GPRD were included in the cohort. New diagnoses of cancer during cohort follow up were compared among exposure groups. In addition to the cohort analyses, solid tumors, as well as breast cancer and colorectal cancer, identified during the cohort follow-up were matched to controls and case-control analyses were performed within the cohort. Results: Compared to metformin, there was no difference in risk of malignant solid tumors or hematological malignancy with other major classes of OHAs in the cohort. The case-control analyses further supported the findings that these OHA classes or their combinations did not alter the risk of malignant solid tumors. iii In the case-control analyses, exposure to insulin was associated with a 64% (95% CI: 1.24, 2.16) higher risk of malignant solid tumors and this risk was modified when combined with different OHAs. When sulfonylurea was added to insulin, the risk of cancer was increased to almost 3 times (OR = 2.75, 95% CI: 1.51, 5.03), while adding metformin to insulin changed the odds ratio to 1.35 (95% CI: 0.94, 1.94). Similar results were found for breast cancer in which insulin was associated with a significant increase of more than 2 times in risk and other OHAs without insulin were not related to altered risk. For colorectal cancer (CRC), both sulfonylurea and TZD were associated with around a 2-fold significant risk increase compared to metformin. The odds of developing CRC were also elevated after starting insulin (OR = 1.41), although this did not reach statistical significance in these data. Conclusion: This study provides evidence that neither sulfonylurea nor TZD substantially alter the risk of solid tumor compared to metformin among type II diabetes patients. Insulin is associated with higher risk of cancer and this risk may be diminished by concomitant use of metformin, but appears to be magnified by concomitant use of sulfonylurea.
Subject (authority = RUETD)
Topic
Public Health
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_3480
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
v, 79 p. : ill.
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Hong Qiu
Subject (authority = ETD-LCSH)
Topic
Non-insulin-dependent diabetes--Treatment
Subject (authority = ETD-LCSH)
Topic
Diabetes—Research
Subject (authority = ETD-LCSH)
Topic
Diabetics
Subject (authority = ETD-LCSH)
Topic
Cancer
Identifier (type = hdl)
http://hdl.rutgers.edu/1782.1/rucore10001600001.ETD.000063573
RelatedItem (type = host)
TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
Identifier (type = local)
rucore19991600001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3930S81
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Qiu
GivenName
Hong
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2011-07-29 12:33:29
AssociatedEntity
Name
Hong Qiu
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

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411648
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Checksum (METHOD = SHA1)
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