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Fatherhood status and risk of prostate cancer: nationwide, population-based case-control study
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
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2013 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 133, no 4, 937-943 p.Article in journal (Refereed) Published
Abstract [en]

Previous studies have shown a decreased risk of prostate cancer for childless men; however, the cause of the association remains to be elucidated. The aim of our study was to assess the risk of prostate cancer by fatherhood status, also considering potential confounding factors. In a case–control study in Prostate Cancer data Base Sweden 2.0, a nationwide, population-based cohort, data on number of children, marital status, education, comorbidity and tumor characteristics obtained through nationwide healthcare registers and demographic databases for 117,328 prostate cancer cases and 562,644 controls, matched on birth year and county of residence, were analyzed. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for prostate cancer overall and by risk category, adjusting for marital status and education. Childless men had a decreased risk of prostate cancer compared to fathers, OR = 0.83 (95% CI = 0.82–0.84), and risk was lower for low-risk prostate cancer, OR = 0.74 (95% CI = 0.72–0.77), than for metastatic prostate cancer, OR = 0.93 (95% CI = 0.90–0.97). Adjustment for marital status and education attenuated the association in the low-risk category, adjusted OR = 0.87 (95% CI = 0.84–0.91), whereas OR for metastatic cancer remained virtually unchanged, adjusted OR = 0.92 (95% CI = 0.88–0.96). Our data indicate that the association between fatherhood status and prostate cancer to a large part is due to socioeconomic factors influencing healthcare-seeking behavior including testing of prostate-specific antigen levels.

Place, publisher, year, edition, pages
John Wiley & Sons, 2013. Vol. 133, no 4, 937-943 p.
Keyword [en]
prostate cancer, epidemiology, case-control studies, hypogonadism, androgens
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cancer and Oncology Urology and Nephrology
URN: urn:nbn:se:umu:diva-70196DOI: 10.1002/ijc.28057ISI: 000320194400017OAI: diva2:619927
Swedish Research Council, 825-2010-5950
Available from: 2013-05-07 Created: 2013-05-07 Last updated: 2015-08-31Bibliographically approved
In thesis
1. Prospective studies of hormonal and life-style related factors and risk of cancer
Open this publication in new window or tab >>Prospective studies of hormonal and life-style related factors and risk of cancer
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Androgens are important in prostate cancer development but how circulating levels of androgens affect risk of prostate cancer of different aggressiveness is not clear. Being childless has been associated with a lower risk of prostate cancer, but it is not clear if this association is causal or a result of residual confounding. Fathering of dizygotic twins, a marker of high fertility, has not been studied in relation to risk of prostate cancer.

Another marker of life-long hormonal exposure is height, which has been associated with increased risk of cancer and cancer death. However, the association to separate cancer sites has not been consistent.

The aims of this thesis were to study hormonal factors (paper I), and proxies of hormonal factors (paper II and III), and risk of prostate cancer; as well as height and risk of cancer and cancer death by separate sites (paper IV).

Methods: Study designs were i) case-control studies, nested within the Västerbotten Intervention Project (paper I), and in Prostate Cancer database Sweden 2.0 (PCBaSe 2.0) (paper II and III), and ii) cohort study, in the Metabolic Syndrome and Cancer project (Me-Can) (paper IV).

Results, prostate cancer: In paper I, increasing levels of serum androgens were not associated with risk of prostate cancer overall or in tumor risk categories. In paper II, childless men had a lower risk of prostate cancer, overall and in all risk categories, compared to fathers, an association which was in part explained by differences in marital status and educational level.  In paper III, fathers of dizygotic twins did not have an increased risk of prostate cancer, either overall or in risk categories, when compared to fathers of singletons.

Results, cancer overall: In paper IV, height was associated with an increased risk of cancer and cancer death overall in both women and men. The strongest association for cancer was to malignant melanoma in both women and men, and for cancer death to post-menopausal breast cancer in women and renal cell carcinoma in men.

Conclusions: These studies indicate that hormonal factors, when studied as serum levels or when studied using proxies of fertility, do not have a major impact on the risk of prostate cancer. The association between height and an increased risk of cancer appears robust for total cancer and cancer death, as well as for several separate cancer sites.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2014. 76 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1648
prostate cancer, epidemiology, androgens, risk factors, fatherhood status, dizygotic twins, height, cohort, case-control, prospective
National Category
Urology and Nephrology Cancer and Oncology
Research subject
Cancer Epidemiology
urn:nbn:se:umu:diva-88308 (URN)978-91-7601-029-7 (ISBN)
Public defence
2014-06-05, Bergasalen, Umeå Universitetssjukhus, byggnad 27, Umeå, 09:00 (Swedish)
Swedish Cancer Society, 11 0471Swedish Research Council, 825-2010-5950
Available from: 2014-05-07 Created: 2014-04-30 Last updated: 2014-12-09Bibliographically approved

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