Abstract
Objectives: There is not much clarity on the metformin's preventive effect in hepatocellular carcinoma (HCC). The aim of this study was to determine the association between metformin use and HCC. Materials and Methods: An electronic search was carried on Web of Science, Scopus, and PubMed/MEDLINE, from January 2010 to January 2022, for 12 years. Case–control and cohort studies were part of the eligible studies. Data were extracted by two independent reviewers. The Newcastle–Ottawa scale was used to check the quality of studies. Results: A total of 928 (872 + 56) studies were identified in our search, among which a total of 623 articles were analyzed after removing the duplicates. After the retrieved papers were analyzed for their titles and abstracts, a total of 575 articles were excluded on the basis of inclusion criteria, respectively. Forty-eight full-text articles were assessed for final data extraction, of which 11 articles were selected. The pooled analysis of included studies showed a combined odds ratio of 0.87; 95% confidence interval 0.86–0.89 for the association between HCC and the use of metformin. It was noticed that all the studies found nonmetformin therapy to entail a higher risk of HCC in comparison to therapy with metformin with the funnel plot showing asymmetric distribution, with Egger's test showing P < 0001. Conclusions: Metformin use reduces the HCC development risk, and therefore, it may be used in diabetics for the prevention of HCC.
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