title: Patients with prostate cancer are less likely to develop oesophageal adenocarcinoma: could androgens have a role in the aetiology of oesophageal adenocarcinoma?
abstract: Oesophageal adenocarcinoma (OAC) is more common in men. Androgens may therefore contribute to the pathogenesis of OAC. Prostate cancer (PC), an androgen sensitive tumor with a long natural history, may allow insights into this putative association. West Midlands Cancer Intelligence Unit data from 1977 to 2004 were examined to identify patients with a first malignant primary of PC. Patients were followed until diagnosis of a second primary cancer, death or end of the time period. Age- and period-adjusted standardized incidence ratios (SIR) were calculated as an estimate of the relative risk of a second malignant primary of the oesophagus. Between 1977 and 2004, 44,819 men within the West Midlands developed PC as a first primary malignancy. After exclusion for lack of follow-up, 38,627 men were eligible, providing 143,526 person years at risk for analysis. 86 second primary oesophageal cancers were observed, compared with 110 expected, resulting in an SIR of 0.78 (95% CI 0.62-0.96). There was a reduced risk of OAC 0.7 (0.5-0.95) but not of oesophageal squamous cell carcinoma (OSCC) 1.03 (0.69-1.47). The risk of developing OAC, but not OSCC, is lower than expected in patients with PC. A diagnosis of PC may be associated with aetiological factors that are negatively associated with OAC, or anti-androgen therapy may influence the development of OAC.
authors.affiliation: Department of Gastroenterology, Sandwell General Hospital, Lyndon, West Bromwich, West Midlands, B71 4HJ, UK. sheldoncooper@hotmail.com
authors.forename: Sheldon C
authors.initials: SC
authors.lastname: Cooper
authors.forename: Stacey
authors.initials: S
authors.lastname: Croft
authors.forename: Rosie
authors.initials: R
authors.lastname: Day
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Thomson
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Trudgill
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D000728:Androgens / Q000502:physiology*; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000728:Androgens