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Photo: KG Pressfoto

Marju Orho-Melander

Professor

Photo: KG Pressfoto

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

Author

  • Konstantinos K. Tsilidis
  • Naomi E. Allen
  • Paul N. Appleby
  • Sabine Rohrmann
  • Ute Noethlings
  • Larraitz Arriola
  • Marc J. Gunter
  • Veronique Chajes
  • Sabina Rinaldi
  • Isabelle Romieu
  • Neil Murphy
  • Elio Riboli
  • Ioanna Tzoulaki
  • Rudolf Kaaks
  • Annekatrin Lukanova
  • Heiner Boeing
  • Tobias Pischon
  • Christina C. Dahm
  • Kim Overvad
  • J. Ramon Quiros
  • Ana Fonseca-Nunes
  • Esther Molina-Montes
  • Diana Gavrila Chervase
  • Eva Ardanaz
  • Kay T. Khaw
  • Nick J. Wareham
  • Nina Roswall
  • Anne Tjonneland
  • Pagona Lagiou
  • Dimitrios Trichopoulos
  • Antonia Trichopoulou
  • Domenico Palli
  • Valeria Pala
  • Rosario Tumino
  • Paolo Vineis
  • H. B(as) Bueno-de-Mesquita
  • Johan Malm
  • Marju Orho-Melander
  • Mattias Johansson
  • Paer Stattin
  • Ruth C. Travis
  • Timothy J. Key

Summary, in English

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.

Department/s

  • Clinical Chemistry, Malmö
  • Diabetes - Cardiovascular Disease
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health

Publishing year

2014

Language

English

Pages

372-381

Publication/Series

International Journal of Cancer

Volume

136

Issue

2

Document type

Journal article

Publisher

John Wiley and Sons

Topic

  • Cancer and Oncology

Keywords

  • type 2 diabetes
  • prostate cancer
  • cohort study
  • androgens
  • insulin-like
  • growth factor proteins

Status

Published

Research group

  • Clinical Chemistry, Malmö
  • Diabetes - Cardiovascular Disease

ISBN/ISSN/Other

  • ISSN: 0020-7136