title: Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition.
abstract: 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.
authors.affiliation: Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Paul N
authors.initials: PN
authors.lastname: Appleby
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Ute
authors.initials: U
authors.lastname: Nöthlings
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gunter
authors.forename: Veronique
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authors.lastname: Chajes
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Neil
authors.initials: N
authors.lastname: Murphy
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Ioanna
authors.initials: I
authors.lastname: Tzoulaki
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
authors.forename: Annekatrin
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authors.lastname: Lukanova
authors.forename: Heiner
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authors.lastname: Boeing
authors.forename: Tobias
authors.initials: T
authors.lastname: Pischon
authors.forename: Christina C
authors.initials: CC
authors.lastname: Dahm
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: J Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Ana
authors.initials: A
authors.lastname: Fonseca-Nunes
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: Diana
authors.initials: D
authors.lastname: Gavrila Chervase
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Kay T
authors.initials: KT
authors.lastname: Khaw
authors.forename: Nick J
authors.initials: NJ
authors.lastname: Wareham
authors.forename: Nina
authors.initials: N
authors.lastname: Roswall
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Johan
authors.initials: J
authors.lastname: Malm
authors.forename: Marju
authors.initials: M
authors.lastname: Orho-Melander
authors.forename: Mattias
authors.initials: M
authors.lastname: Johansson
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Travis
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
mesh_terms: D000328:Adult; D000368:Aged; D000728:Androgens / Q000097:blood; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005060:Europe / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009752:Nutritional Status; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D018969:Insulin-Like Growth Factor Binding Proteins; D013739:Testosterone
keywords: androgens; cohort study; insulin-like growth factor proteins; prostate cancer; type 2 diabetes