BACKGROUND: Few previous studies of metabolic aberrations and prostate cancer risk have taken into account the fact that men with metabolic aberrations have an increased risk of death from causes other than prostate cancer.
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The aim of this study was to calculate, in a real-life scenario, the risk of prostate cancer diagnosis, prostate cancer death, and death from other causes.
METHODS: In the Metabolic Syndrome and Cancer Project, prospective data on body mass index, blood pressure, glucose, cholesterol, and triglycerides were collected from 285,040 men. Risks of prostate cancer diagnosis, prostate cancer death, and death from other causes were calculated by use of competing risk analysis for men with normal (bottom 84%) and high (top 16%) levels of each factor, and a composite score.
RESULTS: During a mean follow-up period of 12 years, 5,893 men were diagnosed with prostate cancer, 1,013 died of prostate cancer, and 26,328 died of other causes. After 1996, when prostate-specific antigen testing was introduced, men up to age 80 years with normal metabolic levels had 13% risk of prostate cancer, 2% risk of prostate cancer death, and 30% risk of death from other causes, whereas men with metabolic aberrations had corresponding risks of 11%, 2%, and 44%.
CONCLUSIONS: In contrast to recent studies using conventional survival analysis, in a real-world scenario taking risk of competing events into account, men with metabolic aberrations had lower risk of prostate cancer diagnosis, similar risk of prostate cancer death, and substantially higher risk of death from other causes compared with men who had normal metabolic levels.
Häggström C, Stocks T, Nagel G, Manjer J, Bjørge T, Hallmans G, Engeland A, Ulmer H, Lindkvist B, Selmer R, Concin H, Tretli S, Jonsson H, Stattin P. Are you the author?
Department of Surgical and Perioperative sciences, Urology and Andrology, Umeå University, Umeå, Sweden; Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Norwegian Institute of Public Health, Oslo/Bergen, Norway; Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden; Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria; Institute of Population-based Cancer Research, The Cancer Registry of Norway, Oslo, Norway; and Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
Reference: Epidemiology. 2014 Nov;25(6):823-8.