The association between paternal prostate cancer and type 2 diabetes.

OBJECTIVE

Increasing evidence indicates that type 2 diabetic patients are at elevated risk for developing different kinds of cancers. However, diabetes mellitus may be a protective factor for prostate cancer since both were found to be negatively associated. Based on the same genetic background, parents of diabetic patients might show similar risks concerning cancers.

RESEARCH DESIGN AND METHODS

We conducted a case-control study, where familiy history of 794 type 2 diabetic cases and 775 non-diabetic controls was ascertained. Then, we expanded our study up to 801 type 2 diabetic cases and 1267 non-diabetic controls.

RESULTS

Concerning the 794 type 2 diabetic patients and 775 controls, we observed that cancer of cervix uteri was elevated among mothers of controls (odds ratio (OR) 0.19; 95% confidence interval (CI) 0.02 to 0.88; p = 0.033). Mothers of diabetic patients showed an increased history of cancers of the liver and biliary tract (OR 5.23; 95% CI 1.87 to 19.9; p = 0.0009) and stomach (OR 3.84; 95% CI 1.47 to 12.4; p = 0.0049). Pancreatic cancers were found to be elevated in fathers of diabetic patients (OR 4.92; 95% CI 1.07 to 46.7; p = 0.039). Most notably, a lower number of prostate cancers was observed in fathers of diabetic patients (OR 0.47; 95% CI 0.22 to 0.94; p = 0.032). Since diabetic patients were 14.3 years older than the controls, higher levels of cancer history among parents of diabetic patients would have been expected. Thus, the observed lower level of history of prostate cancer can be regarded as highly reliable.The analysis of 801 type 2 diabetics and 1267 controls showed that cancer of stomach was elevated among mothers of controls (OR 2.67; p = 0.0106). In addition, stomach cancers were found to be elevated in fathers of diabetic patients (OR 2.10; p = 0.0141). In accordance with the previous investigation, we again obseved a lower number of prostate cancers in fathers of diabetic patients (OR 0.49; p = 0.0279).However, the application of the statistical method of Mantel-Haenszel showed no significant result concerning any of the cancer histories.

CONCLUSION

Fathers of patients suffering from type 2 diabetes were diagnosed less frequently with prostate cancer compared to fathers of non-diabetic controls. As first-degree relatives, e.g. diabetic patients and their fathers, share 50% of their genes, it appears plausible that genetic factors may play an important role in the negative association between diabetes and prostate cancer. However, different statistic analyses showed controversial results concerning the effect of type 2 diabetes on prostate cancers.