Metformin has been associated with a reduced incidence of prostate cancer and improved prostate cancer outcomes. However, whether race modifies the association between metformin use and prostate cancer aggressiveness remains uncertain. The association between metformin use and prostate cancer aggressiveness was examined separately in Black Americans (Blacks) and White Americans (Whites).
The study population consisted of 305 Black and 195 White research participants with incident prostate cancer and self-reported diabetes from the North Carolina-Louisiana Prostate Cancer Project. High-aggressive prostate cancer was defined using a composite measure of Gleason sum, prostate-specific antigen, and clinical stage. Multivariable logistic regression was used to assess the association between metformin use and high-aggressive prostate cancer at diagnosis, separately among Whites and Blacks, with adjustment for age, screening history, site, education, insurance, and body mass index.
Metformin use was associated positively with high-aggressive prostate cancer in Blacks (OR 2.01; 95% CI 1.05, 3.83). By contrast, a weak inverse association between metformin use and high-aggressive prostate cancer was found in Whites (OR 0.80, 95% CI 0.34, 1.85).
The association between metformin use and prostate cancer aggressiveness may be modified by race.
Cancer causes & control : CCC. 2018 Sep 28 [Epub ahead of print]
Saira Khan, Jianwen Cai, Matthew E Nielsen, Melissa A Troester, James L Mohler, Elizabeth T H Fontham, Laura Farnan, Bettina F Drake, Andrew F Olshan, Jeannette T Bensen
Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA. ., Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA., Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA., Department of Urology, School of Medicine, University of North Carolina-Chapel Hill, 170 Manning Dr., Chapel Hill, NC, 27599, USA., School of Public Health, Louisiana State University Health Science Center, 2020 Gravier Street, New Orleans, LA, 70112, USA., Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina-Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA., Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.