Examining the relationship between diabetes and prostate cancer through changes in screening guidelines.

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  • Author(s): Miller EA;Miller EA; Pinsky PF; Pinsky PF
  • Source:
    Cancer causes & control : CCC [Cancer Causes Control] 2020 Dec; Vol. 31 (12), pp. 1105-1113. Date of Electronic Publication: 2020 Sep 24.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Kluwer Academic Publishers Country of Publication: Netherlands NLM ID: 9100846 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-7225 (Electronic) Linking ISSN: 09575243 NLM ISO Abbreviation: Cancer Causes Control Subsets: MEDLINE
    • Publication Information:
      Publication: Dordrecht : Kluwer Academic Publishers
      Original Publication: Oxford, UK : Rapid Communications of Oxford Ltd., 1990-
    • Subject Terms:
      Guidelines as Topic*; Diabetes Mellitus/*epidemiology ; Early Detection of Cancer/*methods ; Mass Screening/*methods ; Prostatic Neoplasms/*epidemiology; Aged ; Diabetes Mellitus/blood ; Diabetes Mellitus/pathology ; Humans ; Incidence ; Kallikreins/blood ; Male ; Neoplasm Grading ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/blood
    • Abstract:
      Purpose: Previous studies have found that men with diabetes are at reduced risk of prostate cancer compared to men without diabetes. The lower risk could be due to biologic differences and/or a diagnosis bias from use of the prostate-specific antigen (PSA) test as a screening and diagnostic tool. We sought to further examine the relationship between diabetes and incidence of prostate cancer and examine the potential impact of changes in PSA screening guidelines in 2008 and 2012.
      Methods: We used 2004-2015 Surveillance, Epidemiology and End Results (SEER)-Medicare data and limited the study population to men aged 67-74 with at least 2 years of continuous enrollment. Using the 5% Medicare sample as the denominator and prostate cancer cases as the numerator, we calculated age-adjusted rate ratios (RR) in 2006-2011 and 2012-2015 by diabetes status, overall and by tumor grade. We used multivariable logistic regression to compare tumor characteristics by diabetes status.
      Results: Men with diabetes had lower incidence rates of prostate cancer compared to men without diabetes in 2006-2011 [RR = 0.89 95% confidence interval (CI) 0.87-0.91] and 2012-2015 (RR = 0.92 95% CI 0.89-0.95) but the slight attenuation toward the null in 2012-2015 was primarily due to the change in RRs for low-grade tumors.
      Conclusion: We found differences in the risk and characteristics of prostate cancer by diabetes status and that some risks have changed over time as guidelines have changed. With lower PSA use in the more recent time-period, rates of low-grade tumors have become more similar by diabetes status.
    • Contributed Indexing:
      Keywords: Diabetes; Population-based; Prostate cancer screening; Prostate-specific antigen
    • Accession Number:
      EC 3.4.21.- (KLK3 protein, human)
      EC 3.4.21.- (Kallikreins)
      EC 3.4.21.77 (Prostate-Specific Antigen)
    • Publication Date:
      Date Created: 20200924 Date Completed: 20201231 Latest Revision: 20211122
    • Publication Date:
      20231215
    • Accession Number:
      10.1007/s10552-020-01347-4
    • Accession Number:
      32970300