Abstract
Personal history of type 2 diabetes mellitus (T2DM) is associated with a lower incidence of prostate cancer, but the underlying mechanisms are largely unknown. We hypothesized that genetic factors that are involved in the development of T2DM might protect against prostate cancer. We used a few Swedish registers, including the Swedish Multigeneration Register and the Cancer Register, to examine the risk of prostate cancer among men with a family history of T2DM. Standardized incidence ratios were used to calculate the relative risk. The overall risk of prostate cancer among men with a familial history of T2DM was 0.87 (95% CI: 0.86-0.89) as compared to matched controls. The risk was even lower for those multiple affected relatives with T2DM, and it was 0.86 for those with two affected relatives and 0.67 for those with three and more affected relatives. Family history of T2DM was associated with a lower incidence of prostate cancer, and the risk was even lower for those with more than one affected relative. Our study strongly suggests that genetic factors or shared familial factors, such as obesity, that contributed to T2DM may protect against prostate cancer.
Highlights
The incidence of type 2 diabetes mellitus (T2DM) has continuously increased worldwide and in Sweden [1], partly due to the increasing trend of obesity, which is one of the main risk factor of T2DM [2]
We explored the hypothesis that genetic factors may partly explain the inverse association between T2DM and prostate cancer by examining the incidence of prostate cancer among Swedish men with a family history of T2DM as compared to men without a family history
In this population-based nationwide cohort study, we found that the overall incidence of prostate cancer was significantly lower when first degree relatives were diagnosed with T2DM as compared to matched controls
Summary
The incidence of type 2 diabetes mellitus (T2DM) has continuously increased worldwide and in Sweden [1], partly due to the increasing trend of obesity, which is one of the main risk factor of T2DM [2]. The US Multiethnic Cohort study found that the frequency of PSA testing is around 44% in diabetics, whereas the frequency is 48 in nondiabetics [8] Other factors, such as low-androgen level in T2DM as well as the protective effects of diabetes medication [9], may contribute to the lower incidence of prostate cancer. It is still unknown whether genetic factors that are involved in the development of T2DM might protect against prostate cancer. Personal history of type 2 diabetes mellitus (T2DM) is associated with a lower incidence of prostate cancer, but the underlying mechanisms are largely unknown. We hypothesized that genetic factors that are involved in the development of T2DM might protect against prostate cancer
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