Advanced

Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Tsilidis, Konstantinos K.; Allen, Naomi E.; Appleby, Paul N.; Rohrmann, Sabine; Noethlings, Ute; Arriola, Larraitz; Gunter, Marc J.; Chajes, Veronique; Rinaldi, Sabina and Romieu, Isabelle, et al. (2014) In International Journal of Cancer 136(2). p.372-381
Abstract
The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass... (More)
The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer. What's new? Emerging evidence suggests that men with type 2 diabetes are at lower risk to develop prostate cancer. Using data obtained within the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors show that the prostate cancer risk was, indeed, reduced by 26% in men with type 2 diabetes but no association with cancer stage or grade was observed. In a subset of men for whom data on circulating hormones were available, levels of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in those with diabetes as compared to those without diabetes, giving clues to how having diabetes could affect prostate cancer development. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
type 2 diabetes, prostate cancer, cohort study, androgens, insulin-like, growth factor proteins
in
International Journal of Cancer
volume
136
issue
2
pages
372 - 381
publisher
John Wiley & Sons
external identifiers
  • wos:000344596600015
  • scopus:84926642161
ISSN
0020-7136
DOI
10.1002/ijc.28989
language
English
LU publication?
yes
id
35ed8a2f-1955-4c8f-94ee-c2f74a3d4e80 (old id 4871873)
date added to LUP
2015-01-07 10:41:32
date last changed
2017-11-19 03:08:09
@article{35ed8a2f-1955-4c8f-94ee-c2f74a3d4e80,
  abstract     = {The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer. What's new? Emerging evidence suggests that men with type 2 diabetes are at lower risk to develop prostate cancer. Using data obtained within the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors show that the prostate cancer risk was, indeed, reduced by 26% in men with type 2 diabetes but no association with cancer stage or grade was observed. In a subset of men for whom data on circulating hormones were available, levels of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in those with diabetes as compared to those without diabetes, giving clues to how having diabetes could affect prostate cancer development.},
  author       = {Tsilidis, Konstantinos K. and Allen, Naomi E. and Appleby, Paul N. and Rohrmann, Sabine and Noethlings, Ute and Arriola, Larraitz and Gunter, Marc J. and Chajes, Veronique and Rinaldi, Sabina and Romieu, Isabelle and Murphy, Neil and Riboli, Elio and Tzoulaki, Ioanna and Kaaks, Rudolf and Lukanova, Annekatrin and Boeing, Heiner and Pischon, Tobias and Dahm, Christina C. and Overvad, Kim and Quiros, J. Ramon and Fonseca-Nunes, Ana and Molina-Montes, Esther and Gavrila Chervase, Diana and Ardanaz, Eva and Khaw, Kay T. and Wareham, Nick J. and Roswall, Nina and Tjonneland, Anne and Lagiou, Pagona and Trichopoulos, Dimitrios and Trichopoulou, Antonia and Palli, Domenico and Pala, Valeria and Tumino, Rosario and Vineis, Paolo and Bueno-de-Mesquita, H. B(as) and Malm, Johan and Orho-Melander, Marju and Johansson, Mattias and Stattin, Paer and Travis, Ruth C. and Key, Timothy J.},
  issn         = {0020-7136},
  keyword      = {type 2 diabetes,prostate cancer,cohort study,androgens,insulin-like,growth factor proteins},
  language     = {eng},
  number       = {2},
  pages        = {372--381},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1002/ijc.28989},
  volume       = {136},
  year         = {2014},
}