Serum creatinine and prostate cancer risk in a prospective study

Several studies have examined serum creatinine as a marker for prostate cancer stage, recurrence, and prognosis. We evaluated whether serum creatinine concentration was associated with risk of developing prostate cancer in a prospective cohort of male smokers.

A nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of 50- to 69-year-old Finnish men was conducted. Two controls (n = 464) were matched to each case (n = 232) on study center, intervention group, date of baseline blood draw (+/-45 days), and age (+/-5 years). Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. All P values were two-sided.

Cases had significantly higher prediagnostic serum creatinine concentrations compared with controls (medians of 1.13 versus 1.10 mg/dL, respectively; P = 0.004). Serum creatinine was associated with a significantly greater risk of prostate cancer (multivariate odds ratio, 2.23; 95% confidence interval, 1.33-3.75 for highest versus lowest quartile), with a significant trend (P trend = 0.0008). Exclusion of subjects with a reported history of diabetes, benign prostatic hyperplasia, or hypertension, or whose cancer was diagnosed within the first 5 years of follow-up, did not alter the association. Risk did not differ by disease stage or time from blood draw to diagnosis.

Prospectively measured serum creatinine, within normal ranges, is positively related to prostate cancer risk. Future research should reexamine the association in other populations, including any interrelationship with serum prostate-specific antigen.