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Blood pressure, body size and prostate cancer risk in the Swedish Construction Workers cohort.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
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2010 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 127, no 7, 1660-1668 p.Article in journal (Refereed) Published
Abstract [en]

Data from prospective studies on blood pressure and prostate cancer risk are limited, and results are inconclusive. Baseline measurements of height, weight and blood pressure were available in 336,159 men in the Swedish Construction Workers cohort. During an average of 22.2 years of follow-up, 10,002 incident cases and 2,601 fatal cases of prostate cancer were identified in National registers. For 5,219 cases, tumor characteristics were available; 2,817 tumors were classified as nonaggressive and 2,402 as aggressive. Relative risks of disease were estimated from Cox regression models, using attained age as time-scale, and adjusting for birth year, smoking status and body mass index (BMI). Top compared to bottom quintile level of systolic or diastolic blood pressure was associated with a significant 15-20% decreased risk of incident prostate cancer (p for trend: systolic < 0.0001, diastolic = 0.3), but blood pressure was not significantly associated with risk of fatal prostate cancer. BMI was not associated with prostate cancer incidence, but was positively associated with fatal prostate cancer; men in the top quintile had a 30% increased risk (p for trend = 0.0004). The associations between blood pressure and BMI and nonaggressive tumors were similar to those of incident prostate cancer, and associations with aggressive tumors were similar to those of fatal prostate cancer. Data from our study suggest that hypertension is associated with a decreased risk of incident prostate cancer, but the explanation for this finding is unclear. Our study support a positive association between overweight and risk of fatal prostate cancer.

Place, publisher, year, edition, pages
2010. Vol. 127, no 7, 1660-1668 p.
Keyword [en]
prostatic neoplasms, cohort studies, blood pressure, overweight, body size
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-32700DOI: 10.1002/ijc.25171ISI: 000281340200017PubMedID: 20087861OAI: oai:DiVA.org:umu-32700DiVA: diva2:305199
Note
Articles online in advance of printAvailable from: 2010-03-22 Created: 2010-03-22 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
Open this publication in new window or tab >>Metabolic factors and cancer risk: prospective studies on prostate cancer, colorectal cancer, and cancer overall
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: A large number of prospective studies have shown that overweight and diabetes are related to an increased risk of many cancers, including colorectal cancer. In contrast, diabetes has been related to a decreased risk of prostate cancer, and overweight has been related to an increased risk of fatal, but not of incident, prostate cancer. Data from studies on metabolic factors related to overweight and diabetes, and the association with cancer risk, are limited.

 Aim: The aim of this thesis was to study metabolic factors in relation to risk of prostate cancer (paper I and III), colorectal cancer (paper II and V), and cancer overall (paper VI).

 Methods: Study designs were i) case-control studies, nested within the Northern Sweden Health and Disease Cohort (paper I and II), and ii) cohort studies of the Swedish Construction Workers cohort (paper III), and the Metabolic syndrome and Cancer project (Me-Can) comprising seven European cohorts (paper V and VI). Paper IV was a descriptive paper of Me-Can.

 Results, prostate cancer: In paper I, increasing levels of several factors related to insulin resistance (insulin, insulin resistance index, leptin, HbA1c, and glucose) were associated with a decreased risk of overall incident prostate cancer, and the associations were stronger for non-aggressive tumours. In paper III, increasing levels of blood pressure was associated with a significant decreased risk of overall incident prostate cancer and of non-aggressive tumours. Body mass index (BMI) was significantly positively related to fatal prostate cancer. 

 Results, colorectal cancer: In paper II, obesity, hypertension, and hyperglycaemia, were associated with an increased risk of colorectal cancer, and presence of two or three of these factors was associated with a higher risk than the presence of one single factor. In paper V, BMI was associated with a significant linear positive association with risk of colorectal cancer in men and women, and significant positive associations were also found in men for blood pressure and triglycerides. A high metabolic syndrome score, based on levels of BMI, blood pressure, glucose, cholesterol, and triglycerides, was associated with a significant increased risk of colorectal cancer in men and women. The association was stronger than for any of the factors in single, but there was no evidence of a positive interaction between these metabolic factors.

 Results, cancer overall: Blood glucose was significantly positively associated with risk of incident and fatal cancer overall, and at several specific sites. The associations were stronger in women than in men, and for fatal than for incident cancer.

 Conclusions: Results from these studies indicate that elevated blood glucose is related to an increased risk of cancer overall and at several specific sites, and further, that overweight and metabolic aberrations increase the risk of colorectal cancer in an additive way. The association with prostate cancer seems to be more complex; insulin resistance and high blood pressure were in our studies related to a decreased risk of overall incident prostate cancer and of non-aggressive tumours, whereas overweight increased the risk of fatal prostate cancer.

Place, publisher, year, edition, pages
Umeå: Institutionen för kirurgi och perioperativ vetenskap, 2009. 90 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1267
National Category
Urology and Nephrology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-22567 (URN)978-91-7264-784-8 (ISBN)
Distributor:
Urologi och andrologi, 901 85, Umeå
Public defence
2009-06-05, Sal B, byggnad 1 D, Umeå Universitetssjukhus, Umeå, 13:15 (English)
Opponent
Supervisors
Available from: 2009-05-19 Created: 2009-05-13 Last updated: 2010-03-26Bibliographically approved

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