Journal Article

Association of type 2 diabetes mellitus and antidiabetic medication with risk of prostate cancer: a population-based case-control study

Zethelius, Björn, Van Hemelrijck, Mieke, Stattin, Pär, Adolfsson, Jan, Garmo, Hans, Crawley, Danielle, Lin, E.

2020

Overview

Background Prostate cancer (PCa) and type 2 diabetes mellitus (T2DM) are prevalent conditions that often occur concomitantly. However, many aspects of the impact of T2DM, particularly the duration of T2DM and antidiabetic medications, on PCa risk are poorly understood. Methods To assess the association of duration of T2DM and antidiabetic medication with PCa risk, we designed a matched case-control study, including 31,415 men with PCa and 154,812 PCa-free men in Prostate Cancer data Base Sweden (PCBaSe) 4.1. Results Overall, a decreased risk of PCa was observed for men with T2DM (odds ratio (OR): 0.81, 95% confidence interval (CI): 0.78–0.84), as compared to men without T2DM. The decreased risk of PCa was consistently showed across duration of T2DM. With respect to use of antidiabetic drugs, this inverse association with duration was also found for all medications types, as compared to men without T2DM, including insulin, metformin and sulphonylurea (SU) (e.g. 3- < 5 yr insulin OR:0.69, 95%CI:0.60–0.80; 3- < 5 yr metformin OR: 0.82, 95%CI: 0.74–0.91; 3- < 5 yr SU OR: 0.72, 95%CI: 0.62–0.83). When stratifying by PCa risk categories, this decreased risk was most evident for diagnosis of low and intermediate-risk PCa (low-risk OR: 0.65, 95%CI: 0.66–0.70, intermediate-risk OR: 0.80, 95%CI: 0.75–0.85). Conclusions The study showed an inverse association between pre-existing T2DM and PCa across different durations of T2DM and all types of T2DM medication received. This inverse association was most evident for low- and intermediate-risk PCa, suggesting that whilst T2DM and its medication may protect some men from developing PCa, the relationship warrants further study.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Aged, 80 and over / Antidiabetic medication / Antidiabetics / Biomedical and Life Sciences / Biomedicine / cancer burden and supportive therapy / Cancer Research / Cancer therapies / Case-Control Studies / Diabetes / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - drug therapy / Drug dosages / Drug therapy / Duration / Health Promotion and Disease Prevention / Humans / Hypoglycemic agents / Hypoglycemic Agents - therapeutic use / Identity / Insulin / Male / Medicine/Public Health / Metastasis / Metformin / Middle Aged / Odds Ratio / Oncology / Pharmacy / Population / Population studies / Population-based studies / Prostate cancer / Prostate cancer risk / Prostatic Neoplasms - epidemiology / Prostatic Neoplasms - prevention & control / Registries - statistics & numerical data / Research Article / Risk Factors / Studies / Surgical Oncology / Survivorship / Sweden - epidemiology / Type 2 diabetes / Type 2 diabetes mellitus