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American Journal of Epidemiology Advance Access originally published online on August 11, 2008
American Journal of Epidemiology 2008 168(8):925-931; doi:10.1093/aje/kwn190
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Antidiabetic Medication and Prostate Cancer Risk: A Population-based Case-Control Study

Teemu J. Murtola, Teuvo L. J. Tammela, Jorma Lahtela and Anssi Auvinen

Correspondence to Dr. Teemu J. Murtola, School of Public Health, University of Tampere, Medisiinarinkatu 3, 33520 Tampere, Finland (e-mail: teemu.murtola{at}uta.fi).

Received for publication January 30, 2008. Accepted for publication May 30, 2008.

Decreased risk of prostate cancer in diabetic men has been reported. The authors evaluated the association between antidiabetic medication use and prostate cancer at the population level. All incident prostate cancer cases in Finland during 1995–2002 were identified from the Finnish Cancer Registry. Matched controls were provided by the Population Register Center (24,723 case-control pairs). Information on medication use was obtained from a comprehensive prescription database. Multivariable-adjusted odds ratios were computed by using conditional logistic regression. The authors found that prostate cancer risk was decreased for antidiabetic medication users (odds ratio = 0.87, 95% confidence interval: 0.82, 0.92). The decrease was observed for most drug groups. The odds ratio decreased in a dose-dependent fashion by quantity of use. Duration of antidiabetic treatment was inversely associated with overall prostate cancer risk and risk of advanced cancer. Similar risk reduction for users of different antidiabetic drugs suggests that diabetes, instead of the medication itself, is behind the association. This finding is unlikely to be secondary because of differential uptake of the prostate-specific antigen test or different prostate-specific antigen levels between medication users and nonusers; prevalence of testing in Finland is low. Dose and time dependency of the relation probably indicates that duration of diabetes is negatively associated with risk.

case-control studies; diabetes mellitus; drug therapy; Finland; incidence; population; prostatic neoplasms

Abbreviations: DDD, defined daily dose; PSA, prostate-specific antigen


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