Antidiabetic Treatment in Patients at High Risk for a Subsequent Keratinocyte Carcinoma

Area of Science:

• Dermatology
• Endocrinology
• Oncology

Background:

• Type II diabetes is linked to increased keratinocyte carcinoma (KC) risk.
• Metformin use has been previously associated with a lower KC risk.
• This study investigates sulfonylureas and KC development in patients with a history of KC.

Purpose of the Study:

• To examine the association between sulfonylurea use and the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
• To compare the risk of KC development in patients using sulfonylureas versus non-users.

Main Methods:

• Retrospective cohort study of 932 patients with a history of KC from the Veterans Affairs Keratinocyte Carcinoma Chemoprevention Trial.
• Survival analysis using Cox regression, controlling for BMI, prior BCC/SCC history, and actinic keratoses.
• Analysis compared sulfonylurea users (n=94) to non-users, with 153 patients on metformin.

Main Results:

• Sulfonylurea users showed no statistically significant increased or decreased risk for SCC (HR 0.67, P=0.49) or BCC (HR 0.94, P=0.77) compared to non-users.
• Hazard ratios did not reach statistical significance, indicating no clear association.

Conclusions:

• The use of sulfonylureas was not associated with a significant change in the risk of developing subsequent BCC or SCC in patients with a history of KC.
• Metformin may be a preferred agent over sulfonylureas for diabetic patients at high risk for KC.