Hormone-related diseases and prostate cancer: an English national record linkage study

Insulin‐like growth factor‐I (IGF‐I) and testosterone may be related to prostate cancer risk. Acromegaly is associated with clinically high IGF‐I concentrations. Klinefelter's syndrome, testicular hypofunction and hypopituitarism are associated with clinically low testosterone concentrations. W...

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Main Authors: Watts, E, Goldacre, R, Key, T, Allen, N, Travis, R, Perez-Cornago, A
Format: Journal article
Language:England
Published: Wiley 2019
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author Watts, E
Goldacre, R
Key, T
Allen, N
Travis, R
Perez-Cornago, A
author_facet Watts, E
Goldacre, R
Key, T
Allen, N
Travis, R
Perez-Cornago, A
author_sort Watts, E
collection OXFORD
description Insulin‐like growth factor‐I (IGF‐I) and testosterone may be related to prostate cancer risk. Acromegaly is associated with clinically high IGF‐I concentrations. Klinefelter's syndrome, testicular hypofunction and hypopituitarism are associated with clinically low testosterone concentrations. We aimed to investigate whether diagnosis with these conditions was associated with subsequent prostate cancer diagnosis and mortality. We used linked English national Hospital Episode Statistics and mortality data from 1999 to 2017 to construct and follow‐up cohorts of men aged ≥35 years diagnosed with (i ) acromegaly (n = 2,495) and (ii ) hypogonadal‐associated diseases (n = 18,763): Klinefelter's syndrome (n = 1,992), testicular hypofunction (n = 8,086) and hypopituitarism (n = 10,331). We estimated adjusted hazard ratios (HRs) and confidence intervals (CIs) for prostate cancer diagnosis and death using Cox regression in comparison with an unexposed reference cohort of 4.3 million men, who were admitted to hospital for a range of minor surgeries and conditions (n observed cases = 130,000, n prostate cancer deaths = 30,000). For men diagnosed with acromegaly, HR for prostate cancer diagnosis was 1.33 (95% CI 1.09–1.63; p = 0.005; n observed cases = 96), HR for prostate cancer death was 1.44 (95% CI 0.92–2.26; p = 0.11; n deaths = 19). Diagnosis with Klinefelter's syndrome was associated with a lower prostate cancer risk (HR = 0.58, 95% CI 0.37–0.91; p = 0.02; n observed cases = 19) and hypopituitarism was associated with a reduction in prostate cancer death (HR = 0.53, 95% CI 0.35–0.79; p = 0.002; n deaths = 23). These results support the hypothesised roles of IGF‐I and testosterone in prostate cancer development and/or progression. These findings are important because they provide insight into prostate cancer aetiology.
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spelling oxford-uuid:ef182f5e-1057-4331-87ea-49b9a1376f442022-03-27T11:37:50ZHormone-related diseases and prostate cancer: an English national record linkage studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ef182f5e-1057-4331-87ea-49b9a1376f44EnglandSymplectic Elements at OxfordWiley2019Watts, EGoldacre, RKey, TAllen, NTravis, RPerez-Cornago, AInsulin‐like growth factor‐I (IGF‐I) and testosterone may be related to prostate cancer risk. Acromegaly is associated with clinically high IGF‐I concentrations. Klinefelter's syndrome, testicular hypofunction and hypopituitarism are associated with clinically low testosterone concentrations. We aimed to investigate whether diagnosis with these conditions was associated with subsequent prostate cancer diagnosis and mortality. We used linked English national Hospital Episode Statistics and mortality data from 1999 to 2017 to construct and follow‐up cohorts of men aged ≥35 years diagnosed with (i ) acromegaly (n = 2,495) and (ii ) hypogonadal‐associated diseases (n = 18,763): Klinefelter's syndrome (n = 1,992), testicular hypofunction (n = 8,086) and hypopituitarism (n = 10,331). We estimated adjusted hazard ratios (HRs) and confidence intervals (CIs) for prostate cancer diagnosis and death using Cox regression in comparison with an unexposed reference cohort of 4.3 million men, who were admitted to hospital for a range of minor surgeries and conditions (n observed cases = 130,000, n prostate cancer deaths = 30,000). For men diagnosed with acromegaly, HR for prostate cancer diagnosis was 1.33 (95% CI 1.09–1.63; p = 0.005; n observed cases = 96), HR for prostate cancer death was 1.44 (95% CI 0.92–2.26; p = 0.11; n deaths = 19). Diagnosis with Klinefelter's syndrome was associated with a lower prostate cancer risk (HR = 0.58, 95% CI 0.37–0.91; p = 0.02; n observed cases = 19) and hypopituitarism was associated with a reduction in prostate cancer death (HR = 0.53, 95% CI 0.35–0.79; p = 0.002; n deaths = 23). These results support the hypothesised roles of IGF‐I and testosterone in prostate cancer development and/or progression. These findings are important because they provide insight into prostate cancer aetiology.
spellingShingle Watts, E
Goldacre, R
Key, T
Allen, N
Travis, R
Perez-Cornago, A
Hormone-related diseases and prostate cancer: an English national record linkage study
title Hormone-related diseases and prostate cancer: an English national record linkage study
title_full Hormone-related diseases and prostate cancer: an English national record linkage study
title_fullStr Hormone-related diseases and prostate cancer: an English national record linkage study
title_full_unstemmed Hormone-related diseases and prostate cancer: an English national record linkage study
title_short Hormone-related diseases and prostate cancer: an English national record linkage study
title_sort hormone related diseases and prostate cancer an english national record linkage study
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AT goldacrer hormonerelateddiseasesandprostatecanceranenglishnationalrecordlinkagestudy
AT keyt hormonerelateddiseasesandprostatecanceranenglishnationalrecordlinkagestudy
AT allenn hormonerelateddiseasesandprostatecanceranenglishnationalrecordlinkagestudy
AT travisr hormonerelateddiseasesandprostatecanceranenglishnationalrecordlinkagestudy
AT perezcornagoa hormonerelateddiseasesandprostatecanceranenglishnationalrecordlinkagestudy