uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (10 of 117) Show all publications
Häggström, C., Jonsson, H., Björge, T., Nagel, G., Manjer, J., Ulmer, H., . . . Stocks, T. (2020). Linear age-course effects on the associations between body mass index, triglycerides, and female breast and male liver cancer risk: An internal replication study of 800,000 individuals. International Journal of Cancer, 146(1), 58-67
Open this publication in new window or tab >>Linear age-course effects on the associations between body mass index, triglycerides, and female breast and male liver cancer risk: An internal replication study of 800,000 individuals
Show others...
2020 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 146, no 1, p. 58-67Article in journal (Refereed) Published
Abstract [en]

Apart from the consistently observed differential association between obesity and breast cancer risk by menopausal status, the associations between obesity and other metabolic imbalances with risks of cancers have not been systematically investigated across the age-course. We created two random 50-50% cohorts from six European cohorts comprising 813,927 individuals. In the "discovery cohort", we used Cox regression with attained age as time-scale and tested interactions between body mass index (BMI), blood pressure, plasma glucose, triglycerides and cholesterol, and attained age in relation to cancer risk. Results with a p-value below 0.05 were additionally tested in the "replication cohort" where a replicated result was considered evidence of a linear interaction with attained age. These findings were investigated by flexible parametric survival models for any age-plateaus in their shape of associations with cancer risk across age. Consistent with other studies, BMI was negatively related to breast cancer risk (n cases = 11,723) among younger (premenopausal) women. However, the association remained negative for several years after menopause and, although gradually weakening over age, the association became positive only at 62 years of age. This linear and positive age-interaction was also found for triglycerides and breast cancer, and for BMI and triglycerides in relation to liver cancer among men (n cases = 444). These findings are unlikely to be due to chance owing to the replication. The linear age-interactions in breast cancer may suggest an influence by other age-related factors than menopause; however, further investigation of age-related effect modifiers in both breast and liver cancer is needed.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
survival analysis, cohort study, metabolic factors, cancer risk, age interaction
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-398025 (URN)10.1002/ijc.32240 (DOI)000495546500009 ()30815851 (PubMedID)
Funder
Swedish Research Council, 2015-02332
Available from: 2019-12-05 Created: 2019-12-05 Last updated: 2019-12-12Bibliographically approved
Loeb, S., Cazzaniga, W., Robinson, D., Garmo, H. & Stattin, P. (2020). Opioid Use after Radical Prostatectomy: Nationwide, Population Based Study in Sweden. Journal of Urology, 203(1), 145-150
Open this publication in new window or tab >>Opioid Use after Radical Prostatectomy: Nationwide, Population Based Study in Sweden
Show others...
2020 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 203, no 1, p. 145-150Article in journal (Refereed) Published
Abstract [en]

PURPOSE: North American studies have revealed that about 3% to 7% of opioid naïve surgical patients transition to chronic opioid use after a single prescription. We examined the risk of chronic opioid use following radical prostatectomy using nationwide Swedish data.

MATERIALS AND METHODS: A total of 25,703 men in the National Prostate Cancer Register of Sweden who underwent radical prostatectomy were linked to the Prescribed Drug Register. Opioid use was assessed at 3 times, including baseline (13 months to 1 month preoperatively), perioperatively (1 month before and after) and postoperatively (1 to 12 months). Multivariable logistic regression was done to identify predictors of new late use (1 or more opioid prescriptions in 3 consecutive months more than 2 months after surgery).

RESULTS: Overall 16,368 men (64%) filled an opioid prescription during the 13 months before or after surgery. The use of strong opioids increased with time and the use of weak opioids decreased. Of the men 1.9% had opioid prescriptions during the baseline period, followed by a spike to 59% around the time surgery, which sharply decreased in month 2 postoperatively. However, thereafter the proportion of men with opioid prescriptions remained slightly higher at 2.2% compared to the baseline before radical prostatectomy. Of chronic late users 57% were previous users and 43% were new chronic users. Higher cancer risk category, greater comorbidity, unmarried status and low educational level were associated with the risk of new chronic opioid use.

CONCLUSIONS: Slightly more than half of male Swedish patients filled an opioid prescription after radical prostatectomy and less than 1% became chronic opioid users. These rates are lower than in previous studies of postoperative opioid use from North America.

Keywords
Sweden, analgesics, opioid, opioid-related disorders, pain, prostatic neoplasms
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-406002 (URN)10.1097/JU.0000000000000451 (DOI)000507630700019 ()31584849 (PubMedID)
Available from: 2020-03-03 Created: 2020-03-03 Last updated: 2020-05-08
Zelic, R., Garmo, H., Zugna, D., Stattin, P., Richiardi, L., Akre, O. & Pettersson, A. (2020). Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study. European Urology, 77(2), 180-188
Open this publication in new window or tab >>Predicting Prostate Cancer Death with Different Pretreatment Risk Stratification Tools: A Head-to-head Comparison in a Nationwide Cohort Study
Show others...
2020 (English)In: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 77, no 2, p. 180-188Article in journal (Refereed) Published
Abstract [en]

Background: Numerous pretreatment risk classification tools are available for prostate cancer. Which tool is best in predicting prostate cancer death is unclear.

Objective: To systematically compare the prognostic performance of the most commonly used pretreatment risk stratification tools for prostate cancer.

Design, setting, and participants: A nationwide cohort study was conducted, including 154 811 men in Prostate Cancer data Base Sweden (PCBaSe) 4.0 diagnosed with nonmetastatic prostate cancer during 1998-2016 and followed through 2016.

Outcome measurements and statistical analysis: We compared the D'Amico, National Institute for Health and Care Excellence (NICE), European Association of Urology (EAU), Genito-Urinary Radiation Oncologists of Canada (GUROC), American Urological Association (AUA), National Comprehensive Cancer Network (NCCN), and Cambridge Prognostic Groups (CPG) risk group systems; the Cancer of the Prostate Risk Assessment (CAPRA) score; and the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram in predicting prostate cancer death by estimating the concordance index (C-index) and the observed versus predicted cumulative incidences at different follow-up times.

Results and limitations: A total of 139 515 men were included in the main analysis, of whom 15 961 died from prostate cancer during follow-up. The C-index at 10 yr of follow-up ranged from 0.73 (95% confidence interval [CI]: 0.72-0.73) to 0.81 (95% CI: 0.80-0.81) across the compared tools. The MSKCC nomogram (C-index: 0.81, 95% CI: 0.80-0.81), CAPRA score (C-index: 0.80, 95% CI: 0.79-0.81), and CPG system (C-index: 0.78, 95% CI: 0.78-0.79) performed the best. The order of performance between the tools remained in analyses stratified by primary treatment and year of diagnosis. The predicted cumulative incidences were close to the observed ones, with some underestimation at 5 yr. It is a limitation that the study was conducted solely in a Swedish setting (ie, case mix).

Conclusions: The MSKCC nomogram, CAPRA score, and CPG risk grouping system performed better in discriminating prostate cancer death than the D'Amico and D'Amico-derived systems (NICE, GUROC, EAU, AUA, and NCCN). Use of these tools may improve clinical decision making.

Patient summary: There are numerous pretreatment risk classification tools that can aid treatment decision for prostate cancer. We systematically compared the prognostic performance of the most commonly used tools in a large cohort of Swedish men with prostate cancer. The Memorial Sloan Kettering Cancer Center nomogram, Cancer of the Prostate Risk Assessment score, and Cambridge Prognostic Groups performed best in predicting prostate cancer death. The use of these tools may improve treatment decisions. 

Place, publisher, year, edition, pages
ELSEVIER, 2020
Keywords
Pretreatment risk stratification, Prognostic model, Prostate cancer
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-405337 (URN)10.1016/j.eururo.2019.09.027 (DOI)000507362200009 ()31606332 (PubMedID)
Funder
Swedish Cancer Society, 2011/825Stockholm County Council
Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-03-04Bibliographically approved
Papadimitriou, N., Muller, D., van den Brandt, P. A., Geybels, M., Patel, C. J., Gunter, M. J., . . . Tsilidis, K. K. (2019). A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study. European Journal of Nutrition
Open this publication in new window or tab >>A nutrient-wide association study for risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition and the Netherlands Cohort Study
Show others...
2019 (English)In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed) Published
Abstract [en]

Purpose: The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive.

Methods: A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR < 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS).

Results: A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS.

Conclusions: Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature.

 

Keywords
Diet, Nutrition, Epidemiology, Cohort study, Prostate cancer
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-397652 (URN)10.1007/s00394-019-02132-z (DOI)000495235600001 ()31705265 (PubMedID)
Funder
Swedish Cancer SocietySwedish Research Council
Note

From WoS: Early access - [The article] have been peer-reviewed and accepted for publication. The article content has been finalized, but it has not been assigned to an issue yet.

Available from: 2019-12-03 Created: 2019-12-03 Last updated: 2019-12-03Bibliographically approved
Sverrisson, I., Folkvaljon, F., Chabok, A., Stattin, P., Smedh, K. & Nikberg, M. (2019). Anastomotic leakage after anterior resection in patients with rectal cancer previously irradiated for prostate cancer. European Journal of Surgical Oncology, 45(3), 341-346
Open this publication in new window or tab >>Anastomotic leakage after anterior resection in patients with rectal cancer previously irradiated for prostate cancer
Show others...
2019 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 45, no 3, p. 341-346Article in journal (Refereed) Published
Abstract [en]

Introduction:

There are little data on the post-operative outcome of anterior resection (AR) for rectal cancer in men who had received radiotherapy for prostate cancer previously. The aim of this study was to assess the rate of anastomotic leakage (AL) after AR in these patients.

Methods:

All men who underwent bowel resection because of rectal cancer between 2000 and 2016 and had been diagnosed previously with prostate cancer were identified by linking the Swedish Colorectal Cancer Registry with the National Prostate Cancer Register. The medical records of men who underwent AR and had previously received radiotherapy for prostate cancer were reviewed.

Results:

In total, 13299 men had undergone a bowel resection for rectal cancer, 188 of whom had previously received radiotherapy for prostate cancer. Among those who had received radiation therapy, 59 men (31%) had an AR: 50 men (85%) received a diverting ileostomy, 42 men (71%) had an American Society of Anesthesiologists score of 1-2 and 36 men (61%) had tumour stage 1-2. AL was found in 12/59 men (20%), one of whom had a re-laparotomy. There was no 90-day mortality.

Conclusions:

In the combined national population-based registries, a minority of patients with rectal cancer had an AR after previous radiotherapy for prostate cancer. These patients were healthy with early cancer stages and, in this selected group of patients, the AL rate was much lower than that reported previously.

Keywords
Rectal cancer, Prostate cancer, Complications, Anastomotic leakage, Radiation therapy
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-381093 (URN)10.1016/j.ejso.2018.11.015 (DOI)000461411100008 ()30503046 (PubMedID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2020-05-18Bibliographically approved
Beckmann, K., Garmo, H., Adolfsson, J., Bosco, C., Johansson, E., Robinson, D., . . . Van Hemelrijck, M. (2019). Androgen Deprivation Therapies and Changes in Comorbidity: A Comparison of Gonadotropin-releasing Hormone Agonists and Antiandrogen Monotherapy as Primary Therapy in Men with High-risk Prostate Cancer. European Urology, 75(4), 676-683
Open this publication in new window or tab >>Androgen Deprivation Therapies and Changes in Comorbidity: A Comparison of Gonadotropin-releasing Hormone Agonists and Antiandrogen Monotherapy as Primary Therapy in Men with High-risk Prostate Cancer
Show others...
2019 (English)In: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 75, no 4, p. 676-683Article in journal (Refereed) Published
Abstract [en]

Background: Some studies suggest that gonadotropin-releasing hormone (GnRH) agonists are associated with higher risk of adverse events than antiandrogens (AAs) monotherapy. However, it has been unclear whether this is due to indication bias.

Objective: To investigate rates of change in comorbidity for men on GnRH agonists versus AA monotherapy in a population-based register study.

Design, setting, and participants: Men with advanced nonmetastatic prostate cancer (PCa) who received primary AA (n = 2078) or GnRH agonists (n = 4878) and age- and area-matched PCa-free men were selected from Prostate Cancer Database Sweden 3.0. Increases in comorbidity were measured using the Charlson Comorbidity Index (CCI), from 5 yr before through to 5 yr after starting androgen deprivation therapy (ADT).

Outcome measures and statistical methods: Multivariable linear regression was used to determine differences in excess rate of CCI change before and after ADT initiation. Risk of any incremental change in CCI following ADT was assessed using multivariable Cox regression analyses.

Results and limitations: Men on GnRH agonists experienced a greater difference in excess rate of CCI change after starting ADT than men on AA monotherapy (5.6% per yr, p < 0.001). Risk of any new CCI change after ADT was greater for GnRH agonists than for AA (hazard ratio, 1.32; 95% confidence interval, 1.20-144).

Conclusions: Impact on comorbidity was lower for men on AA monotherapy than for men on GnRH agonists. Our results should be confirmed through randomised trials of effectiveness and adverse effects, comparing AA monotherapy and GnRH agonists in men with advanced nonmetastatic PCa who are unsuitable for curative treatment.

Patient summary: Hormone therapies for advanced prostate cancer can increase the risk of other diseases (eg, heart disease, diabetes). This study compared two common forms of hormone therapy and found that the risk of another serious disease was higher for those on gonadotropin-releasing hormone agonists than for those on antiandrogen monotherapy.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE BV, 2019
Keywords
Androgen deprivation therapy, Antiandrogen monotherapy, Comorbidity, Gonadotropin-releasing hormone agonists, Prostate cancer
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-380435 (URN)10.1016/j.eururo.2018.11.022 (DOI)000461049200041 ()30497883 (PubMedID)
Funder
Swedish Cancer Society
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-04-09Bibliographically approved
Robinson, D., Garmo, H., Van Hemelrijck, M., Damber, J.-E., Bratt, O., Holmberg, L., . . . Adolfsson, J. (2019). Androgen deprivation therapy for prostate cancer and risk of dementia. BJU International, 124(1), 87-92
Open this publication in new window or tab >>Androgen deprivation therapy for prostate cancer and risk of dementia
Show others...
2019 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 124, no 1, p. 87-92Article in journal (Refereed) Published
Abstract [en]

Objectives

To study whether androgen deprivation therapy (ADT), the mainstay treatment for advanced and disseminated prostate cancer, is associated with risk of dementia.

Methods

Risk of dementia in men with prostate cancer primarily managed with ADT or watchful waiting (WW) in the Prostate Cancer Database Sweden, PCBaSe, was compared with that in prostate cancer-free men, matched on birth year and county of residency. We used Cox regression to calculate the hazard ratios (HRs) for Alzheimer's and non-Alzheimer's dementia (vascular dementia, dementia secondary to other diseases or unspecified dementias) for different types and duration of ADT and oral antiandrogens (AAs) as well as for men managed with WW.

Results

A total of 25 967 men with prostate cancer and 121 018 prostate cancer-free men were followed for a median of 4 years. In both groups 6% of the men were diagnosed with dementia. In men with prostate cancer, gonadotropin-releasing hormone agonist treatment ( HR 1.15, 95% confidence interval [CI] 1.07-1.23) and orchiectomy (HR 1.60, 95% CI 1.32-1.93) were associated with an increased risk of dementia, as compared to no treatment in prostate cancer-free men; however, this increase in risk was only observed for non-Alzheimer's dementia and occurred from year 1-4 after start of ADT. No increase in risk for any type of dementia was observed for men treated with AAs or for men on WW.

Conclusion

This population-based cohort study does not support previous observations of an increased risk of Alzheimer's dementia for men on ADT; however, there was a small increase in risk of non-Alzheimer's dementia.

Keywords
androgen deprivation therapy, dementia, #ProstateCancer, #PCSM, #ADT, #Dementia
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-388761 (URN)10.1111/bju.14666 (DOI)000471830900016 ()30637900 (PubMedID)
Funder
Swedish Research Council, 825-2012-5047Swedish Cancer Society, 16-0700Swedish Cancer Society, 16-286Swedish Cancer Society, 16-464
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-14Bibliographically approved
Thomsen, F. B., Bosco, C., Garmo, H., Adolfsson, J., Hammar, N., Stattin, P. & Van Hemelrijck, M. (2019). Anti-androgen monotherapy versus gonadotropin-releasing hormone agonists in men with advanced, non-metastatic prostate cancer: a register-based, observational study. Acta Oncologica, 58(1), 110-118
Open this publication in new window or tab >>Anti-androgen monotherapy versus gonadotropin-releasing hormone agonists in men with advanced, non-metastatic prostate cancer: a register-based, observational study
Show others...
2019 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 58, no 1, p. 110-118Article in journal (Refereed) Published
Abstract [en]

Background:

In randomised controlled trials, men with advanced, non-metastatic prostate cancer (PCa) treated with anti-androgen monotherapy (AA) had similar all-cause mortality as men treated with gonadotropin-releasing hormone (GnRH) agonists. Using real-world evidence (i.e., observational data), we aimed to further assess the difference in mortality between these two drug categories.

Material and Methods:

We emulated a trial using data from Prostate Cancer data Base Sweden 3.0. We specifically focused on men diagnosed in 2006-2012 with high-risk PCa who had no distant metastasis. They either received primary hormonal therapy with AA (n=2078) or GnRH agonists (n=4878) who were followed for a median time of 5 years. Risk of death from PCa and other causes was assessed using competing risk analyses and Cox proportional hazards regression analyses, including propensity score matching.

Results:

The cumulative 5-year PCa mortality was lower for men treated with AA (16% [95% confidence interval, CI, 15-18%]) than men treated with GnRH agonists (22% [95% CI 21-24%]). The 5-year other cause mortality was also lower for men on AA (17% [95% CI 15-19%] compared to men on GnRH agonists (27% [95% CI 25-28%]). In regression analyses, the risk of PCa death was similar, GnRH agonists versus AA (reference), hazard ratio (HR) 1.08 (95% CI 0.95-1.23), but the risk of death from all causes was higher for men on GnRH agonists, HR 1.23 (95% CI 1.13-1.34). Consistent results were seen in the propensity score-matched cohort.

Conclusion:

Our results indicate that the use of AA as primary hormonal therapy in men with high-risk non-metastatic PCa does not increase PCa-specific mortality compared to GnRH. Using AA instead of GnRH agonists may result in shorter time on/exposure to GnRH-treatment, which may reduce the risk of adverse events associated with this treatment.

National Category
Cancer and Oncology Urology and Nephrology Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-379242 (URN)10.1080/0284186X.2018.1529427 (DOI)000459620200015 ()30375907 (PubMedID)
Funder
Swedish Research Council, 825-2012-5047
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2020-03-25Bibliographically approved
Bjørge, T., Häggström, C., Ghaderi, S., Nagel, G., Manjer, J., Tretli, S., . . . Engeland, A. (2019). BMI and weight changes and risk of obesity-related cancers: a pooled European cohort study. International Journal of Epidemiology, 48(6), 1872-1885
Open this publication in new window or tab >>BMI and weight changes and risk of obesity-related cancers: a pooled European cohort study
Show others...
2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 6, p. 1872-1885Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Obesity is an established risk factor for several cancers. Adult weight gain has been associated with increased cancer risk, but studies on timing and duration of adult weight gain are relatively scarce. We examined the impact of BMI (body mass index) and weight changes over time, as well as the timing and duration of excess weight, on obesity- and non-obesity-related cancers.

METHODS: We pooled health data from six European cohorts and included 221 274 individuals with two or more height and weight measurements during 1972-2014. Several BMI and weight measures were constructed. Cancer cases were identified through linkage with national cancer registries. Hazard ratios (HRs) of cancer with 95% confidence intervals (CIs) were derived from time-dependent Cox-regression models.

RESULTS: During follow-up, 27 881 cancer cases were diagnosed; 9761 were obesity-related. The HR of all obesity-related cancers increased with increasing BMI at first and last measurement, maximum BMI and longer duration of overweight (men only) and obesity. Participants who were overweight before age 40 years had an HR of obesity-related cancers of 1.16 (95% CI 1.02, 1.32) and 1.15 (95% CI 1.04, 1.27) in men and women, respectively, compared with those who were not overweight. The risk increase was particularly high for endometrial (70%), male renal-cell (58%) and male colon cancer (29%). No positive associations were seen for cancers not regarded as obesity-related.

CONCLUSIONS: Adult weight gain was associated with increased risk of several major cancers. The degree, timing and duration of overweight and obesity also seemed to be important. Preventing weight gain may reduce the cancer risk.

Keywords
BMI and weight changes, Obesity-related cancers, cohort study
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-406289 (URN)10.1093/ije/dyz188 (DOI)000509522900021 ()31566221 (PubMedID)
Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-03-23Bibliographically approved
Beckmann, K., Russell, B., Josephs, D., Garmo, H., Häggström, C., Holmberg, L., . . . Adolfsson, J. (2019). Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study. BMC Cancer, 19, Article ID 612.
Open this publication in new window or tab >>Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study
Show others...
2019 (English)In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, article id 612Article in journal (Refereed) Published
Abstract [en]

Background: Whether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk.

Methods: Fifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007-2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug registers. Associations were investigated using conditional logistic regression, including for disease/drug subtypes and exposure length/dose.

Results: Men with a history of any CID had slightly increased risk of any prostate cancer diagnosis (OR: 1.08; 95%CI: 1.04-1.12) but not unfavourable' (high-risk or advanced) prostate cancer. Generally, risk of prostate cancer was highest for shorter exposure times. However, a positive association was observed for asthma >5years before prostate cancer diagnosis (OR: 1.21; 95%CI: 1.05-1.40). Risk of prostate cancer was increased with prior use of any AIMs (OR: 1.26; 95%CI: 1.24-1.29). A positive trend with increasing cumulative dose was only observed for inhaled glucocorticoids (p<0.011).

Conclusion: Detection bias most likely explains the elevated risk of prostate cancer with prior history of CIDs or use of AIMs, given the higher risk immediately after first CID event and lack of dose response. However, findings for length of time with asthma and dose of inhaled glucocorticoids suggest that asthma may increase risk of prostate cancer through other pathways.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Prostate cancer, Chronic inflammatory disease, Autoimmune disease, Anti-inflammatory medication
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-390092 (URN)10.1186/s12885-019-5846-3 (DOI)000472477600005 ()31226970 (PubMedID)
Funder
Swedish Cancer Society, 2013/472
Available from: 2019-08-05 Created: 2019-08-05 Last updated: 2019-12-12Bibliographically approved
Projects
PCA BASE SWEDEN Prostate cancer studies on large databases in Sweden [2008-05910_VR]; Umeå UniversityProstate cancer research in large Swedish databases. PCBaSe Sweden [2010-05950_VR]; Umeå UniversityPrediction and clinical outcomes in prostate cancer. Studies in large databases [2010-07112_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8306-0687

Search in DiVA

Show all publications