title: Androgen deprivation therapy and the risk of colorectal cancer in patients with prostate cancer.
abstract: OBJECTIVE
  Androgens are known to play an important protective role on colorectal carcinogenesis, and thus the objective of this study was to determine whether androgen deprivation therapy (ADT) is associated with an increased risk of incident colorectal cancer in patients with prostate cancer.
  
  
  METHODS
  We conducted a population-based cohort study within the UK General Practice Research Database population which included all patients newly diagnosed with prostate cancer between 1 January 1988 and 31 December 2008, followed until 31 December 2009. Time-dependent Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) of incident primary colorectal cancer associated with the use of ADT. Secondary analyses considered cumulative duration of use and specific ADTs.
  
  
  RESULTS
  The cohort included a total of 21,503 patients, of whom 184 were diagnosed with colorectal cancer during a mean (SD) follow-up 4.0 (3.0) years (rate 2.4/1,000 person-years). Overall, use of ADT was not associated with an increased risk of colorectal cancer (HR 0.99, 95 % CI 0.73-1.35). Similarly, no association was observed in terms of duration use, although this secondary analysis may have been limited by statistical power. With respect to specific ADTs, bilateral orchiectomy was the only therapy associated with an increased risk of colorectal cancer (HR 2.50, 95 % CI 1.13-5.52).
  
  
  CONCLUSIONS
  Overall, the use of ADT is not associated with an increased risk of incident colorectal cancer. The increased risk observed with bilateral orchiectomy may possibly be due to the prolonged androgen suppression of this therapy.
authors.affiliation: Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Sainte-Catherine, H-425.1, Montreal, QC, H3T 1E2, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Assayag
authors.forename: Hui
authors.initials: H
authors.lastname: Yin
authors.forename: Serge
authors.initials: S
authors.lastname: Benayoun
authors.forename: Michael N
authors.initials: MN
authors.lastname: Pollak
authors.forename: Samy
authors.initials: S
authors.lastname: Suissa
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016001:Confidence Intervals; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000009:adverse effects; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000150:complications / Q000628:therapy*; D012307:Risk Factors
chemical_list: D000726:Androgen Antagonists