Risk for high-grade prostate cancer increased with Type 2 diabetes
MedWire News: Type 2 diabetes patients with prostate cancer who undergo radical prostatectomy are more likely to have advanced grade disease at final pathology than nondiabetics, say researchers.
Furthermore, positive diabetes mellitus status can predict a subsequent finding of high-grade prostate cancer - Gleason score 8 or higher - earlier than treatment, at initial prostate biopsy, says the Italian research team.
"Our findings should be considered when counseling diabetic patients," suggest Firas Abdollah and colleagues from Vita-Salute University in Milan.
"In view of these patients' predisposition to develop a high-grade tumor, regular prostate-specific antigen (PSA) screening may be advised in order to detect prostate cancer at early stages," they add in the journal Prostate Cancer and Prostatic Diseases.
The prevalence of Type 2 diabetes mellitus in a cohort of 2060 patients who underwent prostatectomy between 2001 and 2009 was 7.1%. The researchers tested the hypothesis that these diabetic patients would have a higher incidence of high-grade tumors than their non-diabetic counterparts.
Indeed, after adjustment for potential confounding factors including clinical stage, PSA level, body mass index, and year of treatment, Abdollah and team observed that Type 2 diabetic patients had a 2.7-fold increased risk for having high-grade prostate cancer at initial biopsy.
This trend was mirrored in the final pathology findings at prostatectomy: after adjustment for the same factors, diabetic patients were 2.4 times more likely to have high-grade disease compared with non-diabetic patients.
These risk differences are highlighted by the finding of significantly more disease with a Gleason score of 8 or higher among men with Type 2 diabetes at biopsy (16.3% vs 7.6%) and after prostatectomy (21.1% vs 11.7%) compared with non-diabetic men.
Abdollah et al recommend that their results be verified in a prospective manner before being applied to clinical practice, but they do maintain that theirs is the first analysis of Type 2 diabetes mellitus status and prostatectomy findings in a non-Northern American cohort.
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By Sarah Guy