Cancer Causes Control. 2012 Jun;23(6):819-25. doi: 10.1007/s10552-012-9950-9.
Esophageal adenocarcinoma (EAC) is five times more common among men. EAC tissue exhibits an increased concentration of androgen receptors. We previously reported lower EAC incidence following prostate cancer (PC), suggesting androgen deprivation therapy may reduce EAC incidence, but were unable to demonstrate reducing incidence of EAC with time (latency effect) that would support a cumulative effect of anti-androgen treatment.The Survival Epidemiology and End Results (SEER9) dataset from 1977–2004 was therefore examined to identify subjects with a first malignant primary of PC.Subjects were followed until second primary cancer diagnosis,death, or time period end. Age- and period-adjusted standardized incidence ratios (SIR) were calculated as an estimate of relative risk of an esophageal second malignant primary. Between 1977 and 2004, 343,538 subjects (following exclusion criteria) developed PC as a first primary malignant tumor, providing 2,014,337 years of follow-up.Subsequently 604 esophageal cancers developed, with 763 expected. The incidence of EAC fell following PC [SIR0.83 (95 % CI 0.74–0.93)] with a latency effect identified with SIR 1.1 3 months to 1 year post-PC, SIR 0.85 1–5 years post-PC, and SIR 0.75 greater than five years post-PC. The incidence of esophageal squamous cell carcinoma (ESCC) after PC was also reduced [SIR, 0.79 (0.69-0.89)],with evidence of a latency effect also seen. There is a reduced risk of developing esophageal cancer, both EAC and ESCC, following PC. Androgen deprivation therapy may contribute, but changes in lifestyle following PC diagnosis and decrease in ESCC incidence are also plausible explanations.
食管腺癌 (EAC) 在男性中更为常见,是女性的五倍。EAC 组织表现出雄激素受体的浓度增加。我们之前报道过前列腺癌 (PC) 后 EAC 发病率降低,这表明雄激素剥夺疗法可能降低 EAC 发病率,但未能证明随着时间的推移(潜伏期效应)发病率降低,从而支持抗雄激素治疗的累积效应。因此,检查了 1977 年至 2004 年的生存流行病学和结果 (SEER9) 数据集,以确定首次恶性原发性 PC 的患者。患者随访至第二原发性癌症诊断、死亡或时间段结束。年龄和时期调整的标准化发病率比 (SIR) 作为食管第二恶性原发性的相对风险的估计值计算。1977 年至 2004 年间,343538 例患者(排除标准后)作为第一原发性恶性肿瘤发展为 PC,提供了 2014337 年的随访。随后发展了 604 例食管癌,预期为 763 例。PC 后 EAC 的发病率下降 [SIR0.83(95%CI0.74-0.93)],并确定了潜伏期效应,PC 后 3 个月至 1 年 SIR1.1,PC 后 1-5 年 SIR0.85,PC 后大于 5 年 SIR0.75。PC 后食管鳞状细胞癌 (ESCC) 的发病率也降低 [SIR,0.79(0.69-0.89)],也观察到潜伏期效应的证据。PC 后发生食管癌,包括 EAC 和 ESCC 的风险降低。雄激素剥夺疗法可能有贡献,但 PC 诊断后生活方式的改变和 ESCC 发病率的降低也是合理的解释。