Prostate cancer risk in men with baseline history of coronary artery disease: Results from the REDUCE study - Abstract

BACKGROUND:Coronary artery disease (CAD) and prostate cancer (PCa) are not only common diseases, but share many risk factors.

To date, only a few studies have explored the relationship between CAD and PCa risk, with conflicting results.

METHODS: The four-year REDUCE study tested dutasteride 0.5 mg daily for PCa risk reduction in men with prostate specific antigen (PSA) of 2.5 to 10.0 ng/mL and a negative biopsy. Among men who underwent at least one on-study biopsy (n = 6,729; 82.8%), the association between CAD and overall PCa risk and disease grade was examined with logistic and multinomial logistic regression adjusting for clinicopathologic features, respectively.

RESULTS: Overall, 547 men (8.6%) had a history of CAD. Men with CAD were significantly older and had higher body mass index, PSA, and larger prostate volumes and were more likely to have diabetes, hypertension, and hypercholesterolemia and take aspirin and statins. On multivariate analysis, CAD was associated with a 35% increased risk of PCa diagnosis (OR = 1.35, 95% CI: 1.08-1.67, P = 0.007), while elevating risk of both low- (OR = 1.34, 95% CI: 1.05-1.73, P = 0.02) and high-grade disease (OR = 1.34, 95% CI: 0.95-1.88, P = 0.09).

CONCLUSIONS: In a post hoc hypothesis developing secondary analysis of the REDUCE study, CAD was significantly associated with increased PCa diagnosis.Impact: If confirmed in other studies, this suggests CAD may be a novel PCa risk factor and suggests common shared etiologies. Whether lifestyle changes shown to reduce CAD risk (i.e., weight loss, exercise, cholesterol reduction, etc.) can reduce PCa risk, warrants further study.

Written by:
Thomas JA 2nd, Gerber L, BaƱez LL, Moreira DM, Rittmaster RS, Andriole GL, Freedland SJ. Are you the author?
Surgery Section, Durham VA Medical Center, Durham, North Carolina; Department of Surgery, Duke Prostate Center, Division of Urological Surgery, Durham, North Carolina; Department of Pathology, Duke University School of Medicine, Durham, North Carolina; GlaxoSmithKline, Research Triangle Park, North Carolina; and Washington University School of Medicine in St. Louis, St. Louis, Missouri.

Reference: Cancer Epidemiol Biomarkers Prev. 2012 Feb 20. Epub ahead of print.
doi: 10.1158/1055-9965.EPI-11-1017

PubMed Abstract
PMID: 22315364