Endocrine Abstracts

Introduction: Diabetes as a risk factor of cancer should be explored further. The value of PSA is limited because we cannot exclude prostate cancer in lower PSA levels. We analyzed diabetes and the risk of prostate cancer in lower PSA in a large cohort study.

Method: A total of 179 456 health examinees (men, aged 30–89 years) from 1994 to 2010 were participated. Participants with any cancer or potential prostate diseases were excluded from analysis. Prostate cancer incidence/death outcome was collected from hospital admission records due to prostate cancer from 2002 to 2010.

Result: Serum PSA measurements were divided into seven levels: Q1, 0–0.56, Q2, 0.57–0.79, Q3, 0.80–1.19, Q4, 1.20–2.50, Q5, 2.51–4.00, Q6, 4.01–10.00, and Q7, 10.01 ng/ml and above. The number of prostate cancer cases was 422 within Q1–Q4 and 594 in participants with PSA higher than 2.5 ng/ml. In Q5–7, the prevalence of diabetes was higher than Q1–4 (P for trend<.0001). In Cox proportional hazard models, participants in Q4 showed higher hazard ratios with prostate cancer incidence after adjustment for multiple confounding factors compared to the Q1 group, though they were within the usual normal range. Participants in Q3 and Q4 with PSA lower than 2.50 ng/ml showed significantly higher HRs (Hazard ratio (HR) 6.34, 95% CI 4.40–9.15 in Q4; HR 1.61, 95% CI 1.01–2.45 in Q3).

Conclusion: These findings suggest that examinees with lower PSA than 2.5 might need to be followed up, particularly in diabetes (This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, 14 245 and by the Korea government (MEST) (2011-0029348).