Risk of Colorectal Cancer by Subsite in a Swedish Prostate Cancer Cohort

Lu, Yunxia; Ljung, Rickard; Lindblad, Mats

doi:10.1177/107327481502200222

Cited by 7 publications

(14 citation statements)

References 32 publications

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“…The aforementioned findings contribute significantly to the existing literature, which has yielded variable conclusions regarding the risk for CRC after PC . Possible explanations for these disparities include dissimilarities in study populations or methodological variations.…”

Section: Discussionmentioning

confidence: 69%

“…Prior studies of the overall risk of CRC among PC survivors have varied in their conclusions . Studies exploring the effect of radiation for PC on the subsequent development of CRC have yielded conflicting results, with some reporting a significant increase in the risk of rectal cancer but not colon cancer, with others finding an increased risk of colon cancer but not rectal cancer, and with still others finding no effect .…”

Section: Introductionmentioning

confidence: 99%

“…Studies exploring the effect of radiation for PC on the subsequent development of CRC have yielded conflicting results, with some reporting a significant increase in the risk of rectal cancer but not colon cancer, with others finding an increased risk of colon cancer but not rectal cancer, and with still others finding no effect . Androgen‐deprivation therapy has also been linked with an increased risk of CRC . The majority of these prior studies failed to adjust their models for competing events (eg, the occurrence of other cancers and/or death), which can alter the risk of CRC.…”

Section: Introductionmentioning

confidence: 99%

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Risk of colorectal cancer after the diagnosis of prostate cancer: A population‐based study

Desautels

Czaykowski

Nugent

et al. 2016

Cancer

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BACKGROUND: A rigorous assessment of the risk of colorectal cancer (CRC) among prostate cancer (PC) survivors that controls for important confounding factors and competing risks is necessary to determine the risk of CRC in this population and to inform screening guidelines. METHODS: With data from Manitoba, Canada, subjects diagnosed with PC as their first cancer between 1987 and 2009 were age-matched with up to 5 men with no history of invasive cancer on the PC diagnosis date. Subjects were followed to the date of diagnosis of CRC or another cancer, death, emigration, or the study endpoint (December 31, 2009). Competing risk proportional hazards models were used to compare the CRC incidence between those with PC and those without PC with the following model covariates: history of lower gastrointestinal endoscopy, frequency of health care visits, diabetes, and socioeconomic status. Mutually exclusive competing outcomes included CRC, another primary cancer, and death. RESULTS: For a total of 559,081 personyears, 14,164 men with PC and 69,051 men without PC were followed. Men diagnosed with PC had an increased risk of a subsequent diagnosis of CRC (all CRC: hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.02-1.27; rectal cancer: HR, 1.36; 95% CI, 1.09-1.71). The treatment of PC with radiation was associated with an increased risk for rectal cancer (HR, 2.06; 95% CI, 1.42-2.99) in comparison with PC cases not treated with radiation. CONCLUSIONS: The risk of CRC is increased after a diagnosis of PC and is highest for rectal cancer among those treated with radiation. CRC screening should be considered soon after the diagnosis of PC, especially for men planning for radiotherapy. Cancer 2016;122:1254-60.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk of colorectal cancer after the diagnosis of prostate cancer: A population‐based study

Desautels

Czaykowski

Nugent

et al. 2016

Cancer

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“…In the decades following 1980, the treatment of prostate cancer became more heterogeneous, including prostatectomy, radiotherapy and most notably androgen receptor blockers [15]. Thus, analogous to two previous studies from our group using a similar design, the analyses were stratified for these two time periods to account for this factor [25,26]. Another potential shortcoming of our study was the lack of adjustment for potential confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Exogenous estrogen and the risk of biliary tract cancer – a population-based study in a cohort of Swedish men treated for prostate cancer

Palme-Kilander

Mattsson

et al. 2016

Acta Oncologica

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Background: To assess the role of exogenous estrogen in the etiology of biliary tract cancer, a nationwide population-based cohort study in Sweden was performed. Methods: The study included all men in Sweden with prostate cancer diagnosed in 1961-2008. Due to treatment standards, patients diagnosed in 1961-1980 were considered more exposed to estrogen, while those diagnosed in 1981-2008 were regarded less exposed. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated to estimate the risk of biliary tract cancer in cohort members compared to the corresponding Swedish male population. Results: After 849 307 person-years of follow-up in 203 131 prostate cancer patients, there were 41 incident gallbladder cancers and 36 cancers of the extra-hepatic bile ducts. In overall, there were no apparent differences in the risk of gallbladder cancer or bile duct cancer between patients diagnosed in 1961 -1980 and patients diagnosed in 1981 . However, in patients diagnosed in 1961 -1980, there was a statistically non-significant increased risk of gallbladder cancer (SIR 1.34; 95% CI 0.71-2.29) and extra-hepatic bile duct cancer (SIR 1.20; 95% CI 0.55-2.28)45 years of follow-up after the prostate cancer diagnosis. No such association was found for patients diagnosed in 1981-2008. Sensitivity analyses excluding prostate cancer patients exposed to potential confounding factors did not change the SIRs. Conclusions: Long exposure to high doses of exogenous estrogen might increase the risk of biliary tract cancer. However, any potential excess risk of bile duct cancer resulted by prolonged exposure to high doses of exogenous estrogen seems to be small.

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“…Of these, one found an inverse association between circulating levels of testosterone and CRC risk (9), while four reported inverse associations for sex hormone binding globulin (SHBG) (9,(13)(14)(15), a glycoprotein responsible for sex hormone transportation (17). Furthermore, the risk of CRC has been observed to be higher in prostate cancer patients treated with androgen deprivation therapy (18,19). Taken together, existing studies on the subject, support the hypothesis that sex hormones may play a role in the etiology of male CRC.…”

Section: Introductionmentioning

confidence: 99%

Circulating Sex Hormone Levels and Colon Cancer Risk in Men: A Nested Case–Control Study and Meta-Analysis

Harbs

Rinaldi

Gicquiau

et al. 2022

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Endogenous sex hormones may contribute to higher colorectal cancer incidence rates in men compared to women, but despite an increased number of studies, clear evidence is lacking. Methods:We conducted a comprehensive nested case-control study of circulating concentrations of sex hormones, sex hormone precursors and sex hormone binding globulin (SHBG) in relation to subsequent colon cancer risk in European men. Concentrations were measured using liquid chromatography-tandem mass spectrometry in prospectively collected plasma samples from 690 cases and 690 matched controls from the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Northern Sweden Health and Disease Study (NSHDS) cohorts. Multivariable conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI). In addition, we conducted a metaanalysis of previous studies on men.Results: Circulating levels of testosterone (OR = 0.68, 95% CI = 0.51-0.89) and SHBG (OR = 0.77, 95% CI = 0.62-0.96) were inversely associated with colon cancer risk. For free testosterone, there was a nonsignificant inverse association (OR = 0.83, 95% CI = 0.58-1.18).In a dose-response meta-analysis of endogenous sex hormone levels, inverse associations with colorectal/colon cancer risk were found for testosterone (RR per 100 ng/dL = 0.98, 95% CI = 0.96-1.00, I 2 = 22%) and free testosterone (RR per 10 ng/mL = 0.98, 95% CI = 0.95-1.00, I 2 = 0%). Conclusions:Our results provide suggestive evidence for the association between testosterone, SHBG and male colon cancer development.Impact: Additional support for the involvement of sex hormones in male colon cancer.Research.

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Risk of Colorectal Cancer by Subsite in a Swedish Prostate Cancer Cohort

Abstract: Patients with prostate cancer undergoing bilateral orchiectomy, prostatectomy, or other treatments, including antiandrogen therapy and radiation, may be at increased risk for colorectal adenocarcinoma.

Cited by 7 publications

References 32 publications

Risk of colorectal cancer after the diagnosis of prostate cancer: A population‐based study

Risk of colorectal cancer after the diagnosis of prostate cancer: A population‐based study

Exogenous estrogen and the risk of biliary tract cancer – a population-based study in a cohort of Swedish men treated for prostate cancer

Circulating Sex Hormone Levels and Colon Cancer Risk in Men: A Nested Case–Control Study and Meta-Analysis

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