Skip to main content

Advertisement

SpringerLink
Log in

The relationship between diabetes, prostate-specific antigen screening tests, and prostate cancer

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

A Correction to this article was published on 30 November 2018

This article has been updated

Abstract

Purpose

Men with diabetes have been found to have a reduced risk of prostate cancer (PCa), potentially due to detection bias from lower prostate-specific antigen (PSA) levels or inhibition of tumor growth. Understanding if lower PCa rates are due to a lower risk of the disease or a detection bias from PSA testing can help inform the benefits and harms from prostate cancer screening.

Methods

We used data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial to assess the impact of PSA screening on PCa in men with diabetes and the potential role of detection bias and/or slower tumor growth. Comparing men by diabetes status, we calculated age-adjusted incidence rates by tumor grade and compared screening results, PSA levels, and tumor characteristics.

Results

Men with diabetes had lower rates of PCa but was limited to low- and intermediate-grade tumors. Men with diabetes were less likely to be biopsied after their first positive screening test and men diagnosed with low/intermediate-grade tumors had significantly more advanced tumors with higher PSA levels.

Conclusions

Our findings provide additional evidence that detection bias is likely contributing to the lower rates of low- and intermediate-grade prostate cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Change history

  • 30 November 2018

    In the original publication of the article, the categories of PSA levels among the subpopulation of men diagnosed with prostate cancer were published incorrectly in Table 4. The corrected Table 4 is given in this Correction.

  • 30 November 2018

    In the original publication of the article, the categories of PSA levels among the subpopulation of men diagnosed with prostate cancer were published incorrectly in Table 4. The corrected Table 4 is given in this Correction.

References

  1. Bonovas S, Filioussi K, Tsantes A (2004) Diabetes mellitus and risk of prostate cancer: a meta-analysis. Diabetologia 47(6):1071–1078

    Article  CAS  Google Scholar 

  2. Kasper JS, Giovannucci E (2006) A meta-analysis of diabetes mellitus and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 15(11):2056–2062

    Article  Google Scholar 

  3. Bansal D, Bhansali A, Kapil G, Undela K, Tiwari P (2013) Type 2 diabetes and risk of prostate cancer: a meta-analysis of observational studies. Prostate Cancer Prostatic Dis 16(2):151–158

    Article  CAS  Google Scholar 

  4. Fall K, Garmo H, Gudbjornsdottir S, Stattin P, Zethelius B (2013) Diabetes mellitus and prostate cancer risk; a nationwide case–control study within PCBaSe Sweden. Cancer Epidemiol Biomark Prev 22(6):1102–1109

    Article  CAS  Google Scholar 

  5. Haggstrom C, Van Hemelrijck M, Zethelius B, Robinson D, Grundmark B, Holmberg L et al (2016) Prospective study of type 2 diabetes mellitus, anti-diabetic drugs and risk of prostate cancer. Int J Cancer 140:611–617

    Google Scholar 

  6. Harding JL, Shaw JE, Peeters A, Cartensen B, Magliano DJ (2015) Cancer risk among people with type 1 and type 2 diabetes: disentangling true associations, detection bias, and reverse causation. Diabetes Care 38(4):264–270

    Article  Google Scholar 

  7. Liu X, Hemminki K, Forsti A, Sundquist K, Sundquist J, Ji J (2015) Cancer risk in patients with type 2 diabetes mellitus and their relatives. Int J Cancer 137(4):903–910

    Article  CAS  Google Scholar 

  8. Tsilidis KK, Allen NE, Appleby PN, Rohrmann S, Nothlings U, Arriola L et al (2015) Diabetes mellitus and risk of prostate cancer in the European prospective investigation into cancer and nutrition. Int J Cancer 136(2):372–381

    Article  CAS  Google Scholar 

  9. Zhu K, Lee IM, Sesso HD, Buring JE, Levine RS, Gaziano JM (2004) History of diabetes mellitus and risk of prostate cancer in physicians. Am J Epidemiol 159(10):978–982

    Article  CAS  Google Scholar 

  10. Dankner R, Boffetta P, Keinan-Boker L, Balicer RD, Berlin A, Olmer L et al (2016) Diabetes, prostate cancer screening and risk of low- and high-grade prostate cancer: an 11 year historical population follow-up study of more than 1 million men. Diabetologia 59(8):1683–1691

    Article  CAS  Google Scholar 

  11. Kasper JS, Liu Y, Giovannucci E (2009) Diabetes mellitus and risk of prostate cancer in the health professionals follow-up study. Int J Cancer 124(6):1398–1403

    Article  CAS  Google Scholar 

  12. Leitzmann MF, Ahn J, Albanes D, Hsing AW, Schatzkin A, Chang SC et al (2008) Diabetes mellitus and prostate cancer risk in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Causes Control 19(10):1267–1276

    Article  Google Scholar 

  13. Xu H, Jiang HW, Ding GX, Zhang H, Zhang LM, Mao SH et al (2013) Diabetes mellitus and prostate cancer risk of different grade or stage: a systematic review and meta-analysis. Diabetes Res Clin Pract 99(3):241–249

    Article  Google Scholar 

  14. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Willett WC (1998) Diabetes mellitus and risk of prostate cancer (United States). Cancer Causes Control 9(1):3–9

    Article  CAS  Google Scholar 

  15. Peskoe SB, Joshu CE, Rohrmann S, McGlynn KA, Nyante SJ, Bradwin G et al (2015) Circulating total testosterone and PSA concentrations in a nationally representative sample of men without a diagnosis of prostate cancer. Prostate 75(11):1167–1176

    Article  CAS  Google Scholar 

  16. Barrett-Connor E (1992) Lower endogenous androgen levels and dyslipidemia in men with non-insulin-dependent diabetes mellitus. Ann Intern Med 117(10):807–811

    Article  CAS  Google Scholar 

  17. Betancourt-Albrecht M, Cunningham GR (2003) Hypogonadism and diabetes. Int J Impot Res 15(Suppl 4):S14–S20

    Article  CAS  Google Scholar 

  18. Pierce BL (2012) Why are diabetics at reduced risk for prostate cancer? A review of the epidemiologic evidence. Urol Oncol 30(5):735–743

    Article  Google Scholar 

  19. US Preventive Services Task Force (2017) U.S. Preventive Services Task Force seeks comments on draft recommendation statement on screening for Prostate Cancer. https://www.uspreventiveservicestaskforce.org/Home/GetFile/6/250/prostate-cancer-draft-bulletin/pdf

  20. Grubb RL 3rd, Pinsky PF, Greenlee RT, Izmirlian G, Miller AB, Hickey TP et al (2008) Prostate cancer screening in the prostate, lung, colorectal and ovarian cancer screening trial: update on findings from the initial four rounds of screening in a randomized trial. BJU Int 102(11):1524–1530

    Article  Google Scholar 

  21. Prorok PC, Andriole GL, Bresalier RS, Buys SS, Chia D, Crawford ED et al (2000) Design of the prostate, lung, colorectal and ovarian (PLCO) cancer screening trial. Control Clin Trials 21(6 Suppl):273S–309S

    Article  CAS  Google Scholar 

  22. Rusthoven CG, Carlson JA, Waxweiler TV, Yeh, Raben D, Flaig TW et al (2014) The prognostic significance of Gleason scores in metastatic prostate cancer. Urol Oncol 32(5):707–713

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA

    Eric A. Miller, Paul F. Pinsky & Dudith Pierre-Victor

Authors
  1. Eric A. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul F. Pinsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dudith Pierre-Victor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric A. Miller.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miller, E.A., Pinsky, P.F. & Pierre-Victor, D. The relationship between diabetes, prostate-specific antigen screening tests, and prostate cancer. Cancer Causes Control 29, 907–914 (2018). https://doi.org/10.1007/s10552-018-1067-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-018-1067-3

Keywords

Search

Navigation