研究背景與目的: 糖尿病與癌症是全球性的重大健康議題，而糖尿病與癌症在台灣前十大死因中名列第一位與第四位，糖尿病與某些癌症風險的增加有關。在糖尿病的第一線藥理發現，可能存在抑制癌症的機制並降低得到癌症以及降低死亡風險的效果。因此本研究以台灣健保資料庫，針對癌症病患研究其糖尿病共病症對於使用藥物的存活時間、存活率以及死亡風險的影響，並且以統計方法模型做研究分析。
研究方法: 以台灣健保資料庫2000年百萬抽樣歸人檔為基礎，搜尋2000至2005年間主要診斷為台灣前五大癌症的新個案並持續追蹤至2009年。總共有3,113筆且年齡大於40歲的新個案，主要分為接受二甲雙胍的實驗組以及無接受二甲雙胍的控制組，並使用Logistic-Regression、Survival Analysis、Cox Proportional Hazard等統計方法做一系列的分析比較。
研究結果: 台灣前五大癌症且患有糖尿病共病症下，其有使用二甲雙胍(每福敏)與無使用二甲雙胍兩群組，依據Cox Proportional Hazard調整後模型其結果，其個別癌症之風險值為: 肺癌0.75(95% CI, 0.51-1.01)、肝癌0.83(95% CI, 0.64-1.04)、大腸直腸癌0.73(95% CI, 0.55-0.98)、女性乳癌0.85(95% CI, 0.68-1.04)、口腔癌0.90(95% CI, 0.65-1.18)本研究發現只有大腸直腸癌在統計上有顯著效果。
結論: 本研究發現在經過不同的統計分析方法後，由原先只探討存活與死亡兩狀態，加入了時間因子，可以發現到有使用二甲雙胍治療的群組無論從存活時間、存活率，皆可發現有用二甲雙胍藥物的效果相較為佳。本研究藉由數據以實證醫學的角度分析五大癌症與糖尿病的關係，評估使用二甲雙胍用藥下的效益，提高患者對於藥物治療的信心，爾後可以利於在此種案例下讓醫護人員可以優先考慮是否使用其藥物進行治療。

Background and objective: Being as a global important health issues and top 10 most fatal cancers in Taiwan, diabetes associate with increased risk of certain cancers. At the forefront of diabetes Pharmacology found, it may be inhibited cancer cells, reduce the risk of getting cancer and mortality effect. This study explored the association of diabetes and cancer with diabetes drug(metformin) and investigated whether the positive effect for cancer by conducting the statistical approach.
Methods: Study objects were identified from the NHIRD with diagnosis of cancer between 2000 and 2005 and tracked to 2009. In a cohort of 3,113 patients with cancer and aged over 40 years old, are divided into experimental and control groups. Logistic-Regression, Survival Analysis and Cox Proportional Hazard were used for comparison between groups.
Results: Diabetes comorbidities patients the Top Five Cancers case are divided into treatment and non-treatment groups. According to the Cox proportional hazard model adjusted for age, sex and frequency of drug. It showed a decreased hazard ratio (HR) of 0.75(95% CI, 0.51-1.01) of lung cancer, 0.83(95% CI, 0.64-1.04) of liver cancer, 0.85(95% CI, 0.68-1.04) of breast cancer, 0.90(95% CI, 0.65-1.18) of oral cavity cancer, in patients with treatment, but it was not statistically significant. A significant effect was found between colorectum cancer (HR, 0.73(95% CI, 0.55-0.98)).
Conclusions: This study provides a comprehensive analysis on impacts of diabetes drug with comorbidities in risk of cancers among diabetes patients. The risk may decrease further on patients in using metformin group.

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