Androgen deprivation therapy and cataract incidence among elderly prostate cancer patients in the United States.
OBJECTIVE
The side-effects associated with androgen deprivation therapy (ADT) include weight gain, dyslipidemia, and insulin resistance. As cataracts have been linked to these metabolic abnormalities, an increased risk of cataract may be another adverse consequence of ADT use.


METHODS
Using data from the Surveillance, Epidemiology and End Results-Medicare database, we estimated risk of cataract associated with ADT among 65,852 prostate-cancer patients. ADT treatment was defined as at least one dose of a gonadotropin-releasing hormone agonist or orchiectomy within 6 months after prostate cancer diagnosis. The outcome measure was a first claim of cataract diagnosis identified in Medicare claim files. Cox regression was used to estimate hazard ratios (HR) for the effects of ADT treatment, controlling for confounders.


RESULTS
Gonadotropin-releasing hormone agonist use was associated with a modest increase in cataract incidence (HR 1.09, 95% confidence interval 1.06-1.12). Orchiectomy was also associated with an increased risk of cataract among men with no history of cataract prior to prostate cancer diagnosis (HR 1.26, 95% confidence interval 1.07-1.47).


CONCLUSIONS
In the first systematic investigation of the association between ADT and cataract, our results suggest an elevation in the incidence of cataract among ADT users. Further study, preferably prospective in design, is needed to provide additional evidence to support or refute these findings.
Division of Population Studies and Prevention, Karmanos Cancer Institute, Detroit, MI, USA. dimmerj@karmanos.org
Jennifer
J
Beebe-Dimmer
Hal
H
Morgenstern
Karynsa
K
Cetin
Cecilia
C
Yee
Monina
M
Bartoces
Vahakn
V
Shahinian
Jon
J
Fryzek
John
J
Acquavella
Kendra L
KL
Schwartz
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use*; D002386:Cataract / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D009919:Orchiectomy / Q000009:adverse effects; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012307:Risk Factors; D014481:United States
D000726:Androgen Antagonists