Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Konstantinos K. Tsilidis, Naomi E. Allen, Paul N. Appleby, Sabine Rohrmann, Ute Nöthlings, Larraitz Arriola, Marc J. Gunter, Veronique Chajes, Sabina Rinaldi, Isabelle Romieu, Neil Murphy, Elio Riboli, Ioanna Tzoulaki, Rudolf Kaaks, Annekatrin Lukanova, Heiner Boeing, Tobias Pischon, Christina C. Dahm, Kim Overvad, J. Ramõn QuirõsAna Fonseca-Nunes, Esther Molina-Montes, Diana Gavrila Chervase, Eva Ardanaz, Kay T. Khaw, Nick J. Wareham, Nina Roswall, Anne Tjønneland, Pagona Lagiou, Dimitrios Trichopoulos, Antonia Trichopoulou, Domenico Palli, Valeria Pala, Rosario Tumino, Paolo Vineis, H. Bas Bueno-De-Mesquita, Johan Malm, Marju Orho-Melander, Mattias Johansson, Pär Stattin, Ruth C. Travis, Timothy J. Key

Research output: Contribution to journalArticle

Abstract

The current epidemiologic evidence suggests that men with type 2 diabetes mellitus may be at lower risk of developing prostate cancer, but little is known about its association with stage and grade of the disease. The association between self-reported diabetes mellitus at recruitment and risk of prostate cancer was examined in the European Prospective Investigation into Cancer and Nutrition (EPIC). Among 139,131 eligible men, 4,531 were diagnosed with prostate cancer over an average follow-up of 12 years. Multivariable hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models stratified by EPIC-participating center and age at recruitment, and adjusted for education, smoking status, body mass index, waist circumference, and physical activity. In a subset of men without prostate cancer, the cross-sectional association between circulating concentrations of androgens and insulin-like growth factor proteins with diabetes status was also investigated using linear regression models. Compared to men with no diabetes, men with diabetes had a 26% lower risk of prostate cancer (HR, 0.74; 95% CI, 0.63-0.86). There was no evidence that the association differed by stage (p-heterogeneity, 0.19) or grade (p-heterogeneity, 0.48) of the disease, although the numbers were small in some disease subgroups. In a subset of 626 men with hormone measurements, circulating concentrations of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in men with diabetes compared to men without diabetes. This large European study has confirmed an inverse association between self-reported diabetes mellitus and subsequent risk of prostate cancer. What's new? Emerging evidence suggests that men with type 2 diabetes are at lower risk to develop prostate cancer. Using data obtained within the European Prospective Investigation into Cancer and Nutrition (EPIC), the authors show that the prostate cancer risk was, indeed, reduced by 26% in men with type 2 diabetes but no association with cancer stage or grade was observed. In a subset of men for whom data on circulating hormones were available, levels of androstenedione, total testosterone and insulin-like growth factor binding protein-three were lower in those with diabetes as compared to those without diabetes, giving clues to how having diabetes could affect prostate cancer development.

Original languageEnglish
Pages (from-to)372-381
Number of pages10
JournalInternational Journal of Cancer
Volume136
Issue number2
DOIs
Publication statusPublished - Jan 15 2015

Fingerprint

Prostatic Neoplasms
Diabetes Mellitus
Neoplasms
Type 2 Diabetes Mellitus
Insulin-Like Growth Factor Binding Proteins
Androstenedione
Testosterone
Linear Models
Hormones
Confidence Intervals
Waist Circumference
Somatomedins
Proportional Hazards Models
Androgens
Body Mass Index
Smoking
Exercise
Education

Keywords

  • androgens
  • cohort study
  • insulin-like growth factor proteins
  • prostate cancer
  • type 2 diabetes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Tsilidis, K. K., Allen, N. E., Appleby, P. N., Rohrmann, S., Nöthlings, U., Arriola, L., ... Key, T. J. (2015). Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition. International Journal of Cancer, 136(2), 372-381. https://doi.org/10.1002/ijc.28989

Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition. / Tsilidis, Konstantinos K.; Allen, Naomi E.; Appleby, Paul N.; Rohrmann, Sabine; Nöthlings, Ute; Arriola, Larraitz; Gunter, Marc J.; Chajes, Veronique; Rinaldi, Sabina; Romieu, Isabelle; Murphy, Neil; Riboli, Elio; Tzoulaki, Ioanna; Kaaks, Rudolf; Lukanova, Annekatrin; Boeing, Heiner; Pischon, Tobias; Dahm, Christina C.; Overvad, Kim; Quirõs, J. Ramõn; Fonseca-Nunes, Ana; Molina-Montes, Esther; Gavrila Chervase, Diana; Ardanaz, Eva; Khaw, Kay T.; Wareham, Nick J.; Roswall, Nina; Tjønneland, Anne; Lagiou, Pagona; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Palli, Domenico; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Bueno-De-Mesquita, H. Bas; Malm, Johan; Orho-Melander, Marju; Johansson, Mattias; Stattin, Pär; Travis, Ruth C.; Key, Timothy J.

In: International Journal of Cancer, Vol. 136, No. 2, 15.01.2015, p. 372-381.

Research output: Contribution to journalArticle

Tsilidis, KK, Allen, NE, Appleby, PN, Rohrmann, S, Nöthlings, U, Arriola, L, Gunter, MJ, Chajes, V, Rinaldi, S, Romieu, I, Murphy, N, Riboli, E, Tzoulaki, I, Kaaks, R, Lukanova, A, Boeing, H, Pischon, T, Dahm, CC, Overvad, K, Quirõs, JR, Fonseca-Nunes, A, Molina-Montes, E, Gavrila Chervase, D, Ardanaz, E, Khaw, KT, Wareham, NJ, Roswall, N, Tjønneland, A, Lagiou, P, Trichopoulos, D, Trichopoulou, A, Palli, D, Pala, V, Tumino, R, Vineis, P, Bueno-De-Mesquita, HB, Malm, J, Orho-Melander, M, Johansson, M, Stattin, P, Travis, RC & Key, TJ 2015, 'Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition', International Journal of Cancer, vol. 136, no. 2, pp. 372-381. https://doi.org/10.1002/ijc.28989
Tsilidis, Konstantinos K. ; Allen, Naomi E. ; Appleby, Paul N. ; Rohrmann, Sabine ; Nöthlings, Ute ; Arriola, Larraitz ; Gunter, Marc J. ; Chajes, Veronique ; Rinaldi, Sabina ; Romieu, Isabelle ; Murphy, Neil ; Riboli, Elio ; Tzoulaki, Ioanna ; Kaaks, Rudolf ; Lukanova, Annekatrin ; Boeing, Heiner ; Pischon, Tobias ; Dahm, Christina C. ; Overvad, Kim ; Quirõs, J. Ramõn ; Fonseca-Nunes, Ana ; Molina-Montes, Esther ; Gavrila Chervase, Diana ; Ardanaz, Eva ; Khaw, Kay T. ; Wareham, Nick J. ; Roswall, Nina ; Tjønneland, Anne ; Lagiou, Pagona ; Trichopoulos, Dimitrios ; Trichopoulou, Antonia ; Palli, Domenico ; Pala, Valeria ; Tumino, Rosario ; Vineis, Paolo ; Bueno-De-Mesquita, H. Bas ; Malm, Johan ; Orho-Melander, Marju ; Johansson, Mattias ; Stattin, Pär ; Travis, Ruth C. ; Key, Timothy J. / Diabetes mellitus and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition. In: International Journal of Cancer. 2015 ; Vol. 136, No. 2. pp. 372-381.
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AU - Allen, Naomi E.

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AU - Nöthlings, Ute

AU - Arriola, Larraitz

AU - Gunter, Marc J.

AU - Chajes, Veronique

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AU - Tzoulaki, Ioanna

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AU - Fonseca-Nunes, Ana

AU - Molina-Montes, Esther

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AU - Ardanaz, Eva

AU - Khaw, Kay T.

AU - Wareham, Nick J.

AU - Roswall, Nina

AU - Tjønneland, Anne

AU - Lagiou, Pagona

AU - Trichopoulos, Dimitrios

AU - Trichopoulou, Antonia

AU - Palli, Domenico

AU - Pala, Valeria

AU - Tumino, Rosario

AU - Vineis, Paolo

AU - Bueno-De-Mesquita, H. Bas

AU - Malm, Johan

AU - Orho-Melander, Marju

AU - Johansson, Mattias

AU - Stattin, Pär

AU - Travis, Ruth C.

AU - Key, Timothy J.

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