The association of diabetes with risk of prostate cancer defined by clinical and molecular features
Open Access
- 18 August 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 123 (4), 657-665
- https://doi.org/10.1038/s41416-020-0910-y
Abstract
Background To prospectively examine the association between diabetes and risk of prostate cancer defined by clinical and molecular features. Methods A total of 49,392 men from the Health Professionals Follow-up Study (HPFS) were followed from 1986 to 2014. Data on self-reported diabetes were collected at baseline and updated biennially. Clinical features of prostate cancer included localised, advanced, lethal, low-grade, intermediate-grade, and high-grade. Molecular features includedTMPRSS2: ERGandPTENsubtypes. Cox proportional hazards regression models were used to evaluate the association between diabetes and incidence of subtype-specific prostate cancer. Results During 28 years of follow-up, we documented 6733 incident prostate cancer cases. Relative to men free from diabetes, men with diabetes had lower risks of total (HR: 0.82, 95% CI: 0.75-0.90), localised (HR: 0.82, 95% CI: 0.74-0.92), low-and intermediate-grade prostate cancer (HR: 0.77, 95% CI: 0.66-0.90; HR: 0.77, 95% CI: 0.65-0.91, respectively). For molecular subtypes, the HRs for ERG-negative and ERG-positive cases were 0.63 (0.42-0.95) and 0.72 (0.46-1.12); and for PTEN-intact and PTEN-loss cases were 0.69 (0.48-0.98) and 0.52 (0.19-1.41), respectively. Conclusion Besides providing advanced evidence for the inverse association between diabetes and prostate cancer, this study is the first to report associations between diabetes and ERG/PTEN defined prostate cancers.Funding Information
- China Scholarship Council (201806210455)
- American Cancer Society (MRSG-17-220-01-NEC)
- Foundation for the National Institutes of Health (R00 CA215314, R03CA226942)
- Dana-Farber/Harvard Cancer Center (P30 CA 06516)
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