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Clinical Research

Diabetes and prostate cancer risk in the REDUCE trial

Prostate Cancer and Prostatic Diseases volume 14, pages 326–331 (2011)Cite this article

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Abstract

Men with diabetes mellitus are less likely to be diagnosed with prostate cancer (PCa). As diabetic men have lower serum PSA, it is unclear if this is due to lower PCa incidence or reflects detection bias from fewer PSA-triggered biopsies. To account for differential biopsy rates, we used multivariate regression to examine the link between diabetes and PCa risk in the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial, which required all subjects to undergo biopsy regardless of PSA. We further tested for interaction between diabetes and obesity. Diabetes status and body mass index (BMI) measurements were obtained at baseline. On multivariate analysis, diabetes was not associated with PCa risk (odds ratio (OR) 1.01, 95% confidence interval 0.79–1.30, P=0.92) or risk of low- or high-grade disease (all P⩾0.65). When stratified by obesity, diabetes was also not associated with PCa risk in any BMI category (all P⩾0.15). However, there was suggestion of effect modification by obesity for high-grade disease (P-interaction=0.053). Specifically, diabetes was associated with decreased risk of high-grade PCa in normal-weight men but increased risk in obese men (OR 0.35 vs 1.38). In the REDUCE trial, when all men underwent biopsy, diabetes was not associated with lower PCa risk, but rather equal risk of PCa, low-grade PCa and high-grade PCa.

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Acknowledgements

This work was supported by GlaxoSmithKline. Wu received funding from a Howard Hughes Medical Institute Medical Research Fellows scholarship. Dr Freedland was supported by the Department of Defense Prostate Cancer Research Program and the American Urological Association Foundation/Astellas Rising Star in Urology Award. Views and opinions of, and endorsements by the author(s) do not reflect those of the Department of Defense or its branches and agencies.

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Authors and Affiliations

  1. Duke University School of Medicine, Durham, NC, USA

    C Wu

  2. Urology Section, Durham Veterans Affairs Medical Center, Durham, NC, USA

    C Wu, D M Moreira, L Gerber & S J Freedland

  3. Department of Urology, Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA

    D M Moreira

  4. Duke Prostate Center, Duke University Medical Center, Durham, NC, USA

    L Gerber & S J Freedland

  5. GlaxoSmithKline, Research Triangle Park, NC, USA

    R S Rittmaster

  6. Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in St Louis, St Louis, MO, USA

    G L Andriole

  7. Prostate Study Center, Barnes-Jewish Hospital, St Louis, MO, USA

    G L Andriole

  8. Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA

    S J Freedland

  9. Department of Pathology, Duke University Medical Center, Durham, NC, USA

    S J Freedland

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  1. C Wu
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Correspondence to S J Freedland.

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Competing interests

Dr Rittmaster is an employee of and owns financial stock in GlaxoSmithKline. Drs Andriole and Freedland receive consulting fees from GlaxoSmithKline. Dr Andriole also receives grant support and owns financial stock in GlaxoSmithKline. Wu, Dr Moreira and Gerber declare no conflict of interest.

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Wu, C., Moreira, D., Gerber, L. et al. Diabetes and prostate cancer risk in the REDUCE trial. Prostate Cancer Prostatic Dis 14, 326–331 (2011). https://doi.org/10.1038/pcan.2011.28

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