Audrey Blanc-Lapierre, Pierre I Karakiewicz, Armen Aprikian, Fred Saad and Marie-Ã?lise Parent
Posters-Accepted Abstracts: J Cancer Sci Ther
Objectives: To investigate the relationship between type 2 diabetes mellitus (T2DM) and prostate cancer (PCa) risk in a large population-based caseâ??control study conducted in Montreal, Canada. Subjects & Methods: Cases were 1937 men with histologically-confirmed incident prostate cancer, aged â?¤75 years, diagnosed across French hospitals in the Montreal area between 2005 and 2009. Concurrently, 1995 population controls from the same residential area and age distribution were randomly selected from electoral list of French-speaking men. Detailed lifestyle and medical histories were collected during in person interviews. Prevalence of T2DM was estimated at two years before index date (diagnosis for cases/interview for controls). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between T2DM and PCa risk. Results: T2DM was associated with a reduced risk of PCa (OR=0.60, 95% CI: 0.49-0.74) after adjusting for age, family history of PCa, ancestry, recent PCa screening and education. The association was similar for low-grade cases (Gleason scores less than 7 or [3+4]: OR=0.58, 95% CI: 0.47-0.72) and high-grade cases (Gleason scores greater than 7 or [4+3]: OR=0.67, 95% CI: 0.50- 0.90, p wald test=0.40). The ORs appeared to be lower when T2DM was diagnosed more than four years before index date or when treated with metformin. The risk decrease remained significant among subjects with a history of metabolic syndrome. Conclusion: The negative association observed between T2DM and PCa concords with previous findings. The involvement of insulin and IGF-1 pathways in prostate cancer development has been suggested to explain this inverse relation.
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