title: Diabetes mellitus and prostate cancer risk; a nationwide case-control study within PCBaSe Sweden.
abstract: BACKGROUND
  Diabetes mellitus (DM) increases the risk for cancer at almost all sites, but data on the association with prostate cancer are inconsistent.
  
  
  METHODS
  We assessed the risk of a prostate cancer diagnosis among men with type 2 (T2)DM in a nationwide population-based case-control study including 44,352 men with prostate cancer identified through the Prostate Cancer data Base Sweden (PCBaSe) between 2002 and 2006 and 221,495 age-matched men from the general population.
  
  
  RESULTS
  Overall, the risk of prostate cancer among men with T2DM was lower than among men without T2DM [OR, 0.80; 95% confidence interval (CI), 0.76-0.85]. The risk decreased with longer disease duration and was observed across all tumor risk categories, although most clearly among men with low risk tumors (OR, 0.71; 95% CI, 0.64-0.80). The risk for prostate cancer was reduced among diabetic men on dietary treatment only (OR, 0.89; 95% CI, 0.80-0.99) but more markedly among men on oral hypoglycemic agents (OR, 0.80; 95% CI, 0.74-0.87) and insulin (OR, 0.72; 95% CI, 0.69-0.81). Obese diabetic men (BMI > 30 kg/m(2)) showed a reduced risk (OR, 0.72; 95% CI, 0.65-0.80) compared with men without diabetes. There was a trend of decreasing risk with increasing levels of HbA1c (P < 0.05).
  
  
  CONCLUSIONS
  This nationwide study confirmed a reduced risk of being diagnosed with prostate cancer among men with T2DM, especially for low-risk tumors. An altered hormonal milieu is a plausible explanation, although the possibility of decreased prostate cancer detection among diabetic men cannot be ruled out.
  
  
  CONCLUSIONS
  This is the largest study to examine the association between T2DM and prostate cancer accounting for tumor risk group and diabetes treatment.
authors.affiliation: Clinical Epidemiology and Biostatistics, Örebro University Hospital and University, Örebro, Sweden. Katja.Fall@orebroll.se
authors.forename: Katja
authors.initials: K
authors.lastname: Fall
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.forename: Soffia
authors.initials: S
authors.lastname: Gudbjörnsdottir
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Björn
authors.initials: B
authors.lastname: Zethelius
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; D017430:Prostate-Specific Antigen; C517652:hemoglobin A1c protein, human