Subclinical liver impairment due to fibrosis could influence the development and detectability of prostate cancer. To investigate the association between liver fibrosis and prostate cancer incidence and mortality, we included 5,284 men (mean age: 57. 6 years, 20.1% Black) without cancer or liver disease at Visit 2 in Atherosclerosis Risk in Communities study. Liver fibrosis was assessed using the aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 index (FIB-4), and non-alcoholic fatty liver disease fibrosis score (NFS). Over 25 years, 215 Black and 511 White men were diagnosed prostate cancer, and 26 Black and 51 White men died from the disease. We estimated hazard ratios (HRs) for total and fatal prostate cancer using Cox regression. FIB-4 (quintile 5 versus 1: HR=0.47, 95%CI:0.29-0.77, p-trend=0.004) and NFS (HR=0.56, 95%CI:0.33-0.97, p-trend=0.03) were inversely associated with prostate cancer risk in Black men. Compared with no abnormal score, men with ≥1 abnormal score had a lower prostate cancer risk if they were Black (HR=0.46, 95%CI:0.24-0.89), but not White (HR=1.04, 95% CI:0.69-1.58). Liver fibrosis scores did not appear to be associated with fatal prostate cancer in Black or White men. Among men without a clinical diagnosis of liver disease, higher liver fibrosis scores were associated with lower incidence of prostate cancer in Black men, but not in White men, and not with fatal prostate cancer in either race. Further research is needed to understand the influence of subclinical liver disease on prostate cancer development versus detectability and the racial differences observed.
Cancer prevention research (Philadelphia, Pa.). 2023 Jun 20 [Epub ahead of print]
Anqi Wang, Mariana Lazo, Jiayun Lu, David J Couper, Anna E Prizment, Mara Z Vitolins, Samuel R Denmeade, Corinne E Joshu, Elizabeth A Platz
University of Southern California, Los Angeles, CA, United States., Drexel University, Philadelphia, PA, United States., Johns Hopkins University, United States., University of North Carolina at Chapel Hill, Chapel Hill, NC, United States., University of Minnesota Medical School, Minneapolis, MN, United States., Wake Forest University, Winston-Salem, NC, United States., Johns Hopkins University School of Medicine, Baltimore, MD, United States., Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States., Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.