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Competing risk analysis of metabolic factors and prostate cancer
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Men at risk of prostate cancer are also at risk of competing events but this has been ignored in most studies of metabolic aberrations and prostate cancer. The aim of this study was to assess probabilities of prostate cancer and prostate cancer death by use of competing risk analysis.

Methods: In the Metabolic syndrome and Cancer project (Me-Can), data on body mass index, blood pressure, glucose, total cholesterol, and triglycerides were collected from 285 040 men. Probabilities of prostate cancer, prostate cancer death and competing events, i.e. all-cause death or death from other causes, respectively, were calculated for men with normal (bottom 84%) and high (top 16%) levels of each metabolic factor and a composite score based on all metabolic factors

Results: During follow up, 5893 men were diagnosed with prostate cancer, 1013 men died of prostate cancer, and 26 328 men died of other causes. Men with high levels of metabolic factors had decreased probability of prostate cancer, similar probability of prostate cancer death, and increased probability of other causes of death compared to men with normal levels. After 1996, when prostate specific antigen was used for detection of prostate cancer, men up to 80 years with normal levels of metabolic factors had 13% probability of prostate cancer and 37% probability of death from all causes. For men with high levels of metabolic factors, corresponding probabilities were 12% and 47%.

Conclusions: Men with metabolic aberrations had a decreased probability of prostate cancer but a substantially higher probability of death from all causes.

Keyword [en]
cohort study, competing risk, epidemiology, metabolic factors, prostate cancer
National Category
Cancer and Oncology Urology and Nephrology
Research subject
Epidemiology; Oncology
Identifiers
URN: urn:nbn:se:umu:diva-83945OAI: oai:DiVA.org:umu-83945DiVA: diva2:678035
Funder
Swedish Cancer Society, 2010/628
Available from: 2013-12-11 Created: 2013-12-11 Last updated: 2014-01-15Bibliographically approved
In thesis
1. Metabolic factors and risk of prostate, kidney, and bladder cancer
Open this publication in new window or tab >>Metabolic factors and risk of prostate, kidney, and bladder cancer
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Prostate cancer is the most common cancer in Sweden with around 10,000 new cases every year. Kidney and bladder cancer are less common with 1,000 and 2,000 new cases annually, respectively. The incidence of these cancer sites is higher in developed, than in developing countries, suggesting an association between lifestyle and cancer risk. The aims of this thesis were to investigate body mass index (BMI), blood pressure, and blood levels of glucose, total cholesterol, and triglycerides as risk factors for prostate, kidney, and bladder cancer. Furthermore, we aimed at assess probabilities of prostate cancer and competing events, all-cause death, for men with normal and high levels of metabolic factors.

Material and methods: This thesis was conducted within the Metabolic Syndrome and Cancer project (Me-Can), a pooled cohort study with data from 578,700 participants from Norway, Sweden, and Austria. Data from metabolic factors were prospectively collected at health examinations and linked to the Cancer and Cause of Death registers in each country. 

Results: High levels of metabolic factors were not associated with increased risk of prostate cancer, but high levels of BMI and blood pressure were associated with risk of prostate cancer death. The probability of prostate cancer was higher for men with normal levels of metabolic factors compared to men with high levels, but the probability of all-cause death, was higher for men with high levels than for those with normal levels. For both men and women, high levels of metabolic factors were associated with increased risk of kidney cancer (renal cell carcinoma). Furthermore, blood pressure for men and BMI for women were found as independent risk factors of kidney cancer. High blood pressure was associated with an increased risk of bladder cancer for men.

Conclusions: High levels of metabolic factors were associated to risk of kidney and bladder cancer and to death from kidney, bladder, and prostate cancer. Compared to men with normal levels, men with high levels of metabolic factors had a decreased probability of prostate cancer but an increased probability of all-cause death.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2013. 58 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1612
Keyword
cohort study, competing risk, epidemiology, metabolic factors, prostate cancer, kidney cancer, bladder cancer, renal cell carcinoma, survival analysis
National Category
Urology and Nephrology
Research subject
Epidemiology; Urology; Oncology
Identifiers
urn:nbn:se:umu:diva-83947 (URN)978-91-7459-763-9 (ISBN)
Public defence
2014-01-24, Hörsal E04, byggnad 6E, Norrlands Universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Projects
Me-Can
Funder
Swedish Cancer Society, 2010/628
Note

Ytterligare forskningsfinansiärer: World Cancer Research Fund (2007/09) och Wereld Kanker Onderzoek Fonds (R2010/247)

Available from: 2013-12-17 Created: 2013-12-11 Last updated: 2014-01-15Bibliographically approved

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Häggström, ChristelStocks, TanjaHallmans, GöranJonsson, HåkanStattin, Pär

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