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Association Between Diabetes and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis of Observational
Ana Paula Pagano1, Bruna Ramos da Silva1, Flávio Teixeira Vieira1
1Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
The World Journal of Men'S Health
|July 19, 2024
Summary
Diabetes may protect against early prostate cancer (PC), but evidence for other stages is inconclusive. Further research is needed to clarify the association between diabetes and PC risk across all stages.
Area of Science:
- Oncology
- Metabolic Diseases
- Epidemiology
Background:
- Metabolic diseases, like diabetes mellitus, are increasingly recognized for their potential role in cancer development and progression.
- The specific relationship between diabetes and prostate cancer (PC) risk, particularly across different disease stages, requires further investigation.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on the association between diabetes and the risk of overall, early-stage, and advanced prostate cancer.
- To explore potential protective or risk-modifying effects of diabetes in prostate cancer development.
Main Methods:
- A comprehensive systematic review and meta-analysis of studies published up to September 2023, utilizing databases like MEDLINE, EMBASE, and CINAHL.
- Inclusion criteria focused on cohort and case-control studies assessing prostate cancer risk in adult males with type 2 diabetes mellitus or unspecified diabetes.
- Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method.
Main Results:
- The meta-analysis included 34 studies (26 cohort, 8 case-control), with most examining the association between diabetes and all PC stages combined.
- Diabetes demonstrated a statistically significant protective effect against early-stage PC (Risk Ratio [RR] = 0.71, 95% Confidence Interval [CI] = 0.61-0.83).
- No significant association was found between diabetes and the risk of overall (RR = 0.95, 95% CI = 0.79-1.13) or advanced PC (RR = 0.96, 95% CI = 0.77-1.18).
- The certainty of evidence, according to GRADE, was assessed as very low, with high heterogeneity observed across studies.
Conclusions:
- Diabetes may offer a protective effect against the development of early-stage prostate cancer.
- The evidence linking diabetes to the risk of advanced or overall prostate cancer remains inconclusive, potentially due to significant study heterogeneity.
- These findings may inform risk stratification and screening strategies for prostate cancer in men with diabetes, considering potential impacts on diagnostic markers like prostate-specific antigen.
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