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The effect of androgen deprivation treatment on subsequent risk of bladder cancer diagnosis in male patients treated for prostate cancer

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Abstract

Introduction

Bladder cancer (BCa) is three-to-four times more common in men than in women. To explain this gender gap, several theories have been proposed, including the impact of androgen hormones. The aim of this study was to investigate the differential impact of androgen deprivation therapy (ADT) on subsequent risk of developing BCa in men with prostate cancer (PCa).

Methods

A total of 196,914 patients diagnosed with histologically confirmed localized PCa between 2000 and 2009 were identified in the SEER-Medicare insurance program-linked database. Competing-risk regression analyses were performed to assess the risk of developing BCa adjusting for the risk of all-cause mortality. Univariable and multivariable competing-risk regression analyses were performed to test the effect of ADT on BCa incidence for each PCa treatment modality.

Results

Of the 196,914 individuals included in the study, 68,421 (34.7%) received ADT. Median (IQR) follow-up was 59 (29–95) months. Overall, a total of 2495 (1.3%) individuals developed BCa during follow-up. After stratification according to ADT, the 10-year cumulative incidence rate was 1.75% (95% CI 1.65–1.85). In the untreated group, the 10-year cumulative incidence rate was 1.99% (95% CI 1.83–2.15). In multivariable competing-risk regression, the use of ADT was not associated with BCa, after accounting for the risk of dying from any cause (p = 0.1).

Conclusion

We failed to identify any impact of ADT on the risk of developing a subsequent BCa even after stratifying according to the type of treatment. Further studies are required to explain the gender gap in BCa incidence and outcomes.

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Author information

Author notes

  1. Marco Moschini and Emanuele Zaffuto equally contributed to the manuscript.

Authors and Affiliations

  1. Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy

    Marco Moschini, Emanuele Zaffuto, Giorgio Gandaglia, Nicola Fossati, Francesco Montorsi & Alberto Briganti

  2. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria

    Marco Moschini & Shahrokh F. Shariat

  3. Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland

    Marco Moschini & Agostino Mattei

  4. Department of Urology, University of Montreal, Montreal, QC, Canada

    Emanuele Zaffuto & Pierre Karakiewicz

  5. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria

    Shahrokh F. Shariat

  6. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA

    Shahrokh F. Shariat

  7. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Shahrokh F. Shariat

Authors
  1. Marco Moschini
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Contributions

MM: data collection, statistical analysis, manuscript writing; EZ: data collection, statistical analysis, manuscript writing; PK: project development, manuscript writing; AM: project development, manuscript writing; GG: data collection; NF: data collection; FM: data collection; AB: data collection; SFS: project development, manuscript writing.

Corresponding author

Correspondence to Shahrokh F. Shariat.

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The authors declare that they have no conflict of interest.

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All participants gave their informed consent to use their data for this retrospective study involving human participants.

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Moschini, M., Zaffuto, E., Karakiewicz, P. et al. The effect of androgen deprivation treatment on subsequent risk of bladder cancer diagnosis in male patients treated for prostate cancer. World J Urol 37, 1127–1135 (2019). https://doi.org/10.1007/s00345-018-2504-3

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  • DOI: https://doi.org/10.1007/s00345-018-2504-3

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