An XD, Duan LY, Zhang YH, Jia QY, Zhang YM, Qiao Y. Association between antidiabetic drugs and cancer risk in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis. World J Diabetes 2025; 16(10): 110174 [PMID: 41113488 DOI: 10.4239/wjd.v16.i10.110174]
Corresponding Author of This Article
Yun Qiao, PhD, Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, No. 107 Wenhua Xilu, Jinan 250012, Shandong Province, China. qiaoyun@qiluhospital.com.
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 15, 2025 (publication date) through Oct 22, 2025
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Journal Information of This Article
Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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An XD, Duan LY, Zhang YH, Jia QY, Zhang YM, Qiao Y. Association between antidiabetic drugs and cancer risk in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis. World J Diabetes 2025; 16(10): 110174 [PMID: 41113488 DOI: 10.4239/wjd.v16.i10.110174]
Xue-Dong An, Li-Yun Duan, Department of Endocrinology, Guang’anmen Hospital, Beijing 100053, China
Yue-Hong Zhang, Department of Endocrinology, Fangshan Hospital of Beijing University of Chinese Medicine, Beijing 102400, China
Qian-You Jia, Yan-Min Zhang, Department of Pediatrics, Rizhao Hospital of Traditional Chinese Medicine, Rizhao 276800, Shandong Province, China
Yun Qiao, Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Co-first authors: Xue-Dong An and Li-Yun Duan.
Author contributions: An XD and Duan LY wrote the first draft; An XD and Qiao Y conceived and designed the study; An XD, Jia QY, and Zhang YH analyzed the data; An XD, Duan LY, Zhang YH, Jia QY, Zhang YM, and Qiao Y were involved in data collection. An XD and Duan LY equally contributed to study design and manuscript writing. All authors interpreted the data and critically reviewed the manuscript.
Supported by National Natural Science Foundation of China, No. 82305205; Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine, No. 2023-QNRC2-A05; Safeguard Project of Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. GAMHH9324001; and Special Program for the Training of Outstanding Young Scientific and Technological Talents Under the Basic Scientific Research Operating Expenses of the China Academy of Chinese Medical Sciences, No. ZZ18-YQ-011.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun Qiao, PhD, Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, No. 107 Wenhua Xilu, Jinan 250012, Shandong Province, China. qiaoyun@qiluhospital.com.
Received: June 3, 2025 Revised: June 21, 2025 Accepted: August 22, 2025 Published online: October 15, 2025 Processing time: 138 Days and 3.7 Hours
Abstract
BACKGROUND
Current evidence suggests that commonly used antidiabetic drugs have varying effects on cancer risk. Some antidiabetics offer protective effects against cancer, whereas others may increase risk in specific populations.
AIM
To comprehensively compare the effects of different antidiabetic drugs on the risk of various cancers in patients with type 2 diabetes mellitus (T2DM) through a systematic review and network meta-analysis.
METHODS
Four databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were searched from their inception until April 11, 2025. Published randomized controlled trials that enrolled at least 100 participants and had an intervention duration of at least 1 year were included. The inclusion criteria were studies involving adult patients with T2DM and interventions that compared different classes of antidiabetic drugs with a placebo or another antidiabetic drug. Network meta-analysis was conducted using Stata 17.0 software. Confidence in network meta-analysis was used to assess the quality of evidence regarding the risk of cancer associated with different antidiabetic drugs.
RESULTS
A total of 13535 articles were identified. After applying the inclusion and exclusion criteria, 87 high-quality studies involving 216106 patients and 26 different drugs across seven classes were included in this study. Indirect evidence from network meta-analysis revealed some heterogeneity; however, this did not affect the reliability of the results. The results indicated that antidiabetic drugs did not increase the overall risk of cancer compared with placebo. In contrast, some antidiabetic medications demonstrated a more pronounced advantage in reducing cancer risk, such as dipeptidyl peptidase-4 inhibitors for thyroid and rectal cancers; sodium-glucose co-transporter type 2 inhibitors for lung and bronchial cancers; sulfonylureas for gastric and colon cancers; biguanides for pancreatic cancer; insulin for bladder cancer; glucagon-like peptide-1 receptor agonists for prostate, uterine, hepatocellular, renal, and hematologic cancers; and thiazolidinediones for breast cancer.
CONCLUSION
Antidiabetic drugs reduce cancer risk in patients with T2DM. However, given the limitations in the number and quality of the included studies, our conclusions should be interpreted with caution. More large-scale, high-quality clinical trials are required to validate our findings towards the optimization of comprehensive cancer management strategies for patients with T2DM.
Core Tip: Diabetes has been linked to an increased risk of various cancers. Relevant research indicates that commonly used antidiabetic drugs have varying impacts on cancer risk; some provide protective effects, whereas others may increase the risk in specific populations. We conducted a network meta-analysis to compare the effects of different anti-diabetic drugs on the risk of various cancers in patients with type 2 diabetes mellitus.
