Does coronary artery disease increase risk for a diagnosis of prostate

A study just published on line in Cancer Epidemiology, Biomarkers & Prevention has suggested (albeit not for the first time)? that a baseline history of coronary artery disease may be a meaningful risk factor for prostate cancer.

The new paper by Thomas et al. is based on an analysis of data from the 4-year-long REDUCE study, which was designed to test the impact of treatment with dutasteride (a 5?-reductase inhibitor) on risk for prostate cancer among men with a PSA level of 2.5 to 10.0 ng/ml and an initial negative biopsy. Additional information about this study is provided in a media release from Duke University Health System.

In the study reported by Thomas and his colleagues, the research team looked carefully at the association between a history of heart disease at study entry and a subsequent finding of prostate cancer among the 6,729 participants in the REDUCE study who received at least one on-study biopsy.

Here are the core findings of the analysis:

• 547 participants (8.6 percent) had a baseline history of coronary artery disease.
• Compared to all other participants in this study, the participants with a baseline history of coronary artery disease
  • Were older
  • Had higher body mass indices (BMIs)
  • Had higher PSA levels
  • Had greater prostate volumes
  • Were more likely to have diabetes, hypertension, and high cholesterol levels
  • Were more likely to take aspirin and statins
• A baseline history of coronary artery disease was associated with
  • A 35 percent increase in? risk of prostate cancer diagnosis (OR = 1.35)
  • A 34 percent increase in risk for a diagnosis of low-risk prostate cancer (OR = 1.34)
  • A 34 percent increase in risk for a diagnosis of? high-grade disease (OR = 1.34)
  • A 24 percent increase in risk for a diagnosis of prostate cancer within the first 2 years of the study
  • A 74 percent increase in risk for a diagnosis of prostate cancer at 4 years into the study.

The authors conclude that, based on these data, the presence of coronary artery disease may, in and of itself, be a predictor of increased risk for prostate cancer, but that this hypothesis needs to be confirmed in other studies.

They also note that if this hypothesis is proven to be true, and coronary artery disease and prostate cancer have shared etiologies, then the same strategies that are effective in reducing risk for heart disease (i.e., exercise, weight loss, diet modification, and modifications to cholesterol and triglyceride levels) may well have significant impact on risk for at least some forms of prostate cancer too.

It will not come as news to our regular readers that changes in diet, increased exercise levels, weight loss, and the use of statins to modify cholesterol levels have all been shown to have impact on risk for prostate cancer in the past. Whether prostate cancer and coronary artery disease do, in fact, have a shared etiology, or whether there is some other coincidental association that is responsible for the findings in the current study, may be more difficult to determine. Should it prove to be true, then Dr. Mark Moyad?s long-touted belief that ?heart healthy? behaviors are, de facto, ?prostate healthy? behaviors would finally be validated.

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Filed under: Diagnosis, Management, Risk Tagged: | coronary artery disease, heart disease, risk

Source: http://prostatecancerinfolink.net/2012/02/09/does-coronary-artery-disease-increase-risk-for-a-diagnosis-of-prostate-cancer/

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