Weiderpass Elisabete, Ye Weimin, Vainio Harri, Kaaks Rudolf, Adami Hans-Olov
Unit of Field and Intervention Studies, International Agency for Research on Cancer, 150 Cours Albert-Thomas, F-69372 Lyon Cedex 08, France.
Int J Cancer. 2002 Nov 20;102(3):258-61. doi: 10.1002/ijc.10685.
Although diabetes mellitus is associated with an increased risk of several malignancies, a negative association with prostate cancer is biologically most plausible. The epidemiologic evidence is, however, inconsistent, limited and based mostly on small studies. We present results from a large, population-based cohort study in Sweden, where we assessed prostate cancer risk among patients hospitalized for diabetes mellitus. The cohort was composed of patients identified in the Swedish In-Patient Register as having a hospital discharge diagnosis of diabetes mellitus in 1965-1994. The follow-up was done by linkages with the national cancer register and other population-based registers. Standardized incidence ratios (SIRs), with 95% confidence interval (CI), were used as a measure of relative risk. After complete exclusion of the first year of follow-up (to avoid selection bias), 135,950 men remained in the cohort, contributing 827,099 years of follow-up to the study. A total of 2,455 incident cases of primary prostate cancer were identified during 1-31 years of follow-up, yielding an overall SIR of 0.91 (95% CI 0.87-0.94); this risk reduction was more pronounced among patients who have been hospitalized for diabetic complications (SIR = 0.82; 95% CI 0.74-0.91). We found no consistent trends in risk related to age at first hospitalization or to duration of follow-up. We did find a small, but significantly decreased risk of prostate cancer among men who had been hospitalized for diabetes mellitus.
尽管糖尿病与多种恶性肿瘤风险增加相关，但与前列腺癌呈负相关在生物学上最为合理。然而，流行病学证据并不一致、有限且大多基于小型研究。我们展示了瑞典一项基于人群的大型队列研究结果，在该研究中我们评估了因糖尿病住院患者的前列腺癌风险。该队列由在瑞典住院登记册中确定在1965 - 1994年期间出院诊断为糖尿病的患者组成。通过与国家癌症登记册和其他基于人群的登记册建立联系进行随访。标准化发病比（SIRs）及其95%置信区间（CI）用作相对风险的衡量指标。在完全排除随访的第一年（以避免选择偏倚）后，队列中仍有135,950名男性，为该研究贡献了827,099人年的随访数据。在1 - 31年的随访期间共确定了2455例原发性前列腺癌新发病例，总体标准化发病比为0.91（95% CI 0.87 - 0.94）；这种风险降低在因糖尿病并发症住院的患者中更为明显（标准化发病比 = 0.82；95% CI 0.74 - 0.91）。我们未发现与首次住院年龄或随访时间相关的风险存在一致趋势。我们确实发现因糖尿病住院的男性患前列腺癌的风险略有降低，但具有统计学意义。
