cancer, reduced cancer, diabetes
CANCER, EVENT, DIABETES
A key strength of our study was its prospective design, with regular clinical screening and robust clinical event adjudication that minimized ascertainment bias. Our cohort had detailed baseline data collection with limited missing data, including concise ascertainment of medication use (83% of the study population maintained their baseline status of metformin use or nonuse throughout the follow-up period), and we were able to adjust for a wide range of demographic, lifestyle, and known risk factors. Randomization of participants to aspirin or placebo enabled us to analyze the effect of aspirin among metformin users while minimizing confounding bias.We were limited by the data available to define diabetes, however. Only a single measure of FBGL was collected at enrollment, and HbAIn community-dwelling older people with diabetes, metformin use was associated with reduced cancer incidence. Aspirin use was associated with increased cancer mortality risk in metformin users, but the modification effect of metformin and aspirin did not reach statistical significance. Further research is required to understand the relationship among metformin, aspirin, and cancer risk.