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1.
Anticancer Res ; 40(1): 27-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892550

RESUMO

BACKGROUND/AIM: Even though prostate cancer (PCa) has good prognosis, there is a discrepancy in the risk among ethnic groups, with high morbidity in African American men. Single nucleotide polymorphisms (SNPs) in interleukin 10 (IL-10) have been associated with inflammation and cancer risk. We investigated the association of five SNPs in the IL-10 promoter with clinical features such as Gleason score and smoking. MATERIALS AND METHODS: A total of 413 DNA samples were obtained from a nested case-control study of African American males who were genotyped for 5 SNPs utilizing pyrosequencing. Multiple and binary logistic regression models were applied to analyze the clinical and genotypic data. RESULTS: rs12122923 and rs1800871 were associated with PCa risk. Smoking was also found to increase the risk of PCa by 1.6-fold. rs1800893 was found to be associated with lower grades for prostate cancer. CONCLUSION: IL-10 promoter polymorphisms might be a risk factor for PCa development in smoking subjects and PCa progression.


Assuntos
Afro-Americanos/genética , Interleucina-10/genética , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Neoplasias da Próstata/etiologia , Fumar/efeitos adversos , Idoso , Alelos , Biomarcadores , Estudos de Casos e Controles , Suscetibilidade a Doenças , Genótipo , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Medição de Risco , Fatores de Risco
4.
Int J Cancer ; 146(1): 44-57, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30807653

RESUMO

The associations of individual dietary fatty acids with prostate cancer risk have not been examined comprehensively. We examined the prospective association of individual dietary fatty acids with prostate cancer risk overall, by tumor subtypes, and prostate cancer death. 142,239 men from the European Prospective Investigation into Cancer and Nutrition who were free from cancer at recruitment were included. Dietary intakes of individual fatty acids were estimated using center-specific validated dietary questionnaires at baseline and calibrated with 24-h recalls. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up of 13.9 years, 7,036 prostate cancer cases and 936 prostate cancer deaths were ascertained. Intakes of individual fatty acids were not related to overall prostate cancer risk. There was evidence of heterogeneity in the association of some short chain saturated fatty acids with prostate cancer risk by tumor stage (pheterogeneity < 0.015), with a positive association with risk of advanced stage disease for butyric acid (4:0; HR1SD = 1.08; 95%CI = 1.01-1.15; p-trend = 0.026). There were no associations with fatal prostate cancer, with the exception of a slightly higher risk for those who consumed more eicosenoic acid (22:1n-9c; HR1SD = 1.05; 1.00-1.11; p-trend = 0.048) and eicosapentaenoic acid (20:5n-3c; HR1SD = 1.07; 1.00-1.14; p-trend = 0.045). There was no evidence that dietary intakes of individual fatty acids were associated with overall prostate cancer risk. However, a higher intake of butyric acid might be associated with a higher risk of advanced, whereas intakes of eicosenoic and eicosapentaenoic acids might be positively associated with fatal prostate cancer risk.


Assuntos
Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Neoplasias da Próstata/epidemiologia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
5.
J Urol ; 203(1): 108-114, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31430233

RESUMO

PURPOSE: Compared to urban populations, rural populations rank poorly on numerous health indicators, including cancer outcomes. We examined the relationship of rural residence with stage and treatment among patients with prostate cancer, the second most common malignancy in men. MATERIALS AND METHODS: Using the Pennsylvania Cancer Registry we identified all men diagnosed with prostate cancer between 2009 and 2015. Patients were classified as residing in a rural area, a large town or an urban area using the Rural-Urban Commuting Area classification. Our primary outcomes included indicators of prostate cancer treatment and treatment types but we also examined disease stage and mortality. We used the chi-square tests to assess differences between groups and estimated multivariable logistic regression models to assess the association between rural residence and treatment. RESULTS: We identified 51,024 men diagnosed with localized or metastatic prostate cancer between 2009 and 2015. The overall incidence of prostate cancer decreased during the study period from 416 to 304/100,000 men while the incidence of metastatic disease increased from 336 to 538/100,000. Rural residents were less likely to undergo treatment than urban residents even when stratified by low, intermediate and high risk disease (aOR 0.77, 95% CI 0.64-0.91; aOR 0.71, 95% CI 0.58-0.89; and aOR 0.68, 95% CI 0.53-0.89, respectively). Rural status did not affect the receipt of radiation therapy compared to other treatment types. CONCLUSIONS: Prostate cancer treatment differs between urban and rural residents. Rural residents are less likely to receive treatment even when stratified by disease risk.


Assuntos
Neoplasias da Próstata/terapia , População Rural , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pennsylvania/epidemiologia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Sistema de Registros
6.
Int Braz J Urol ; 46(1): 34-41, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851456

RESUMO

PURPOSE: Prostate cancer screening in the elderly is controversial. The Brazilian government and the National Cancer Institute (INCA) do not recommend systematic screening. Our purpose was to assess prevalence and aggressiveness of prostate cancer in men aged 70 years and above, on the first Latin American database to date. MATERIALS AND METHODS: Cross-sectional study (n=17,571) from 231 municipalities, visited by Mobile Cancer Prevention Units of a prostate-specific antigen (PSA) based opportunistic screening program, between 2004 and 2007. The criteria for biopsy were: PSA>4.0ng/ml, or PSA 2.5-4.0ng/ml with free/total PSA ratio ≤15%, or suspicious digital rectal examination findings. The screened men were stratified in two age groups (45-69 years, and ≥70 years). These groups were compared regarding prostate cancer prevalence and aggressiveness criteria (PSA, Gleason score from biopsy and TNM staging). RESULTS: The prevalence of prostate cancer found was 3.7%. When compared to men aged 45-69 years, individuals aged 70 years and above presented cancer prevalence about three times higher (prevalence ratio 2.9, p<0.01), and greater likelihood to present PSA level above 10.0ng/ml at diagnosis (odds ratio 2.63, p<0.01). The group of elderly men also presented prevalence of histologically aggressive disease (Gleason 8-10) 3.6 times higher (p<0.01), and 5-fold greater prevalence of metastases (PR 4.95, p<0.05). CONCLUSIONS: Prostate cancer screening in men aged over 70 may be relevant in Brazil, considering the absence of systematic screening, higher prevalence and higher probability of high-risk disease found in this age range of the population studied.


Assuntos
Programas de Rastreamento/métodos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biópsia , Brasil/epidemiologia , Estudos Transversais , Exame Retal Digital , Detecção Precoce de Câncer , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prevalência , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Medição de Risco , Fatores de Risco
7.
Medicine (Baltimore) ; 98(52): e18523, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876746

RESUMO

Prostate cancer (PCa) is a frequently diagnosed malignant solid tumor in men. The etiology of PCa has been attributed to both environmental and genetic factors. In recent years, many studies have reported that miRNA gene single-nucleotide polymorphisms (SNPs) influence the susceptibility to several diseases such as cancer. To date, the mechanisms of PCa have remained unknown. The main aim of this study was to evaluate the association between PCa susceptibility and miRNA gene SNPs. A total of 156 PCa cases and 188 control subjects were included in this case-control study. The data were collected from hospitalized cases. We collected the demographic characteristic information, which included age, body mass index, tobacco smoking, alcohol consumption, and family history of cancer. Polymorphisms were analyzed by the ligase detection reaction. Unconditional logistic and stratified analyses were used to analyze the association between these SNPs and PCa susceptibility and to calculate the adjusted odds ratios (ORs) and the 95% confidence intervals (CIs). Cox regression model and the log-rank test were used to test the association between genetic variants and the overall survival. We found that miR-23a gene polymorphism rs3745453 carrying CC homozygotes had a 4.16-fold increased risk (95% CI = 1.30-13.25) than those carrying the TT/CT genotypes (P = .02), and the C allele displayed a higher prevalence of PCa than the T allele (OR = 1.68, 95% CI = 1.16-2.45, P = .01). Moreover, miR-23a showed that the homozygous carriers of the C-variant significantly increased the risk of survival rate as compared to the carriers of the TT/CT genotype (OR = 9.67, 95% CI = 2.83-33.09, P = .001). The rs3745453 polymorphism was potentially associated with PCa in the Chinese Han population and had an interactive relationship with the environmental factors.


Assuntos
Predisposição Genética para Doença/genética , MicroRNAs/genética , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Próstata/genética , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/epidemiologia , Homozigoto , Humanos , Masculino , Neoplasias da Próstata/epidemiologia , Fatores de Risco
8.
Cancer Treat Rev ; 81: 101927, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31783313

RESUMO

Prostate cancer (PCa) remains the most common cancer in men. The proportion of all PCa attributable to high-risk hereditary factors has been estimated to 5-15%. Recent landmark discoveries in PCa genetics led to the identification of germline mutations/alterations (eg. BRCA1, BRCA2, ATM or HOXB13), single nucleotide polymorphisms or copy number variations associated with PCa incidence and progression. However, offering germline testing to men with an assumed hereditary component is currently controversial. In the present review article, we provide an overview about the epidemiology and the genetic basis of PCa predisposition and critically discuss the significance and consequence in the clinical routine. In addition, we give an overview about genetic tests and report latest findings from ongoing clinical studies. Lastly, we discuss the impact of genetic testing in personalized therapy in advanced stages of the disease.


Assuntos
Testes Genéticos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/genética , Proteína BRCA1/genética , Proteína BRCA2/genética , Quinase do Ponto de Checagem 2/genética , Ensaios Clínicos como Assunto , Variações do Número de Cópias de DNA , Predisposição Genética para Doença , Proteínas de Homeodomínio/genética , Humanos , Masculino , Mutação , Polimorfismo de Nucleotídeo Único , Medicina de Precisão/métodos , Neoplasias da Próstata/patologia
9.
Semin Oncol ; 46(4-5): 351-361, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31757478

RESUMO

BACKGROUND: With 1.3 million new cases in 2018 worldwide, prostate cancer remains a challenge. Development of novel therapies targeting the androgen pathway followed recognition of the continued importance of androgens in castrate-resistant prostate cancer. To assess abiraterone and enzalutamide efficacy we analyzed data from US Veterans Administration Medical Centers (VAMCs). METHODS: We used a novel method independent of assessment intervals and ideal for real-world analysis to estimate rates of tumor growth (g) and regression (d). FINDINGS: Using the VA Informatics and Computing Infrastructure, we collected data from 5,116 Veterans with castrate-resistant prostate cancer prescribed abiraterone, enzalutamide or both. We estimated values for g and d and demonstrated a correlation of g with overall survival (P < .0001). Abiraterone and enzalutamide slowed growth rates across age groups and across the entire VAMC system, although less so in Veterans previously treated with a taxane and those with Gleason grade group 5 tumors. Abiraterone and enzalutamide efficacy in first-line were comparable although abiraterone in first-line slowed growth rates significantly more in African Americans than in Caucasians; enzalutamide was a better salvage therapy. When abiraterone was first-line and g was low, switching to enzalutamide was associated with a faster g in 67%. INTERPRETATION: In the real-world g can be estimated using a novel analysis method indifferent to assessment intervals that correlates highly with OS. While we show excellent real-world outcomes with abiraterone and enzalutamide, 2 effective and tolerable therapies, our results in VAMCs suggest enzalutamide should follow abiraterone. Changing therapies may be detrimental and consideration should be given to continue monitoring of growth rates over time. Funding Support from the Prostate Cancer Foundation and the Blavatnik Family Foundation.


Assuntos
Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/terapia , Saúde dos Veteranos , Veteranos , Androstenos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Gerenciamento Clínico , Humanos , Masculino , Feniltioidantoína/administração & dosagem , Feniltioidantoína/análogos & derivados , Neoplasias da Próstata/patologia , Resultado do Tratamento , Estados Unidos/epidemiologia , Saúde dos Veteranos/estatística & dados numéricos
10.
Cancer Invest ; 37(10): 513-523, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31617759

RESUMO

The epidemiology of prostate cancer (PC) continues to change. We evaluated the changes in incidence, in average age at diagnosis, and in survival from 1992 to 2015 in Ontario. We compared the cumulative incidence of PC-specific and non PC-specific mortality using two algorithms for cause of death: Method 1 assigned deaths from "other cancers" to non PC-specific causes, and Method 2 assigned these cases to PC-specific mortality. There were 188,714 cases diagnosed with PC between 1992 and 2015 in Ontario. The average age at diagnosis declined from 1992 to 2008 by 0.26 year (3.1 months) annually (p < 0.001) and increased by 0.15 year (1.8 months) thereafter (p > 0.05). Between 2010 and 2015, the proportion of patients diagnosed at stage IV increased, and the proportion diagnosed at stage I decreased (p-values for trends <0.001). Overall survival significantly improved over the years. The cumulative incidence of PC-specific mortality at 5 and 10 years was 6.8 and 9.8% using Method 1, and 10.2 and 16.8% using Method 2. We observed trends toward older age and more advanced stage at PC diagnosis in Ontario. Further studies are needed to validate algorithms for estimating PC-specific mortality from administrative databases.


Assuntos
Neoplasias da Próstata/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/metabolismo , Sistema de Registros
11.
Asia Pac J Clin Oncol ; 15 Suppl 6: 8-13, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31642191

RESUMO

AIM: The 2017 Advanced Prostate Cancer Consensus Conference (APCCC) convened an international multidisciplinary panel to vote on controversial issues in the management of advanced prostate cancer (APC). We aimed to compare their conclusions with the opinions of local specialists and explore the practicability of international recommendations in the healthcare setting in Hong Kong. METHODS: Urologists and clinical oncologists practicing in Hong Kong were invited to complete a survey based on the original APCCC 2017 questionnaire and recently published trials in APC. A joint committee of expert key opinion leaders was convened to discuss and analyze the voting differences between local specialists and the APCCC 2017 panel. RESULTS: The respondents constituted 21% (28/132) of registered urologists and 21% (31/146) of clinical oncologists in Hong Kong. Discrepancies in three key areas were identified as being the most timely for this analysis: (a) management of metastatic hormone-sensitive/naïve prostate cancer; (b) management of metastatic castration-resistant prostate cancer; and (c) treatment monitoring and initiation of androgen-deprivation therapy. Fears of toxicity and intolerance among patients and physicians (especially urologists) may be driving the relative underuse of chemotherapy in multiple APC patient groups in Hong Kong. Local patients can face long wait times and limited access to contemporary imaging modalities compared with other developed countries. CONCLUSION: Increased collaborative efforts by urologists and clinical oncologists could ensure that patients gain wider access to the latest diagnostic, treatment and monitoring modalities for APC in Hong Kong.


Assuntos
Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/normas , Neoplasias da Próstata/terapia , Inquéritos e Questionários , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos/uso terapêutico , Terapia Combinada , Consenso , Gerenciamento Clínico , Hong Kong/epidemiologia , Humanos , Masculino , Prostatectomia , Neoplasias da Próstata/epidemiologia , Radioterapia
12.
BMJ ; 366: l5214, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31554611

RESUMO

OBJECTIVE: To compare the risk and severity of prostate cancer between men achieving fatherhood by assisted reproduction and men conceiving naturally. DESIGN: National register based cohort study. SETTING: Sweden from January 1994 to December 2014. PARTICIPANTS: 1 181 490 children born alive in Sweden during 1994-2014 to the same number of fathers. Fathers were grouped according to fertility status by mode of conception: 20 618 by in vitro fertilisation (IVF), 14 882 by intra-cytoplasmic sperm injection (ICSI), and 1 145 990 by natural conception. MAIN OUTCOME MEASURES: Prostate cancer diagnosis, age of onset, and androgen deprivation therapy (serving as proxy for advanced or metastatic malignancy). RESULTS: Among men achieving fatherhood by IVF, by ICSI, and by non-assisted means, 77 (0.37%), 63 (0.42%), and 3244 (0.28%), respectively, were diagnosed as having prostate cancer. Mean age at onset was 55.9, 55.1, and 57.1 years, respectively. Men who became fathers through assisted reproduction had a statistically significantly increased risk of prostate cancer compared with men who conceived naturally (hazard ratio 1.64, 95% confidence interval 1.25 to 2.15, for ICSI; 1.33, 1.06 to 1.66, for IVF). They also had an increased risk of early onset disease (that is, diagnosis before age 55 years) (hazard ratio 1.86, 1.25 to 2.77, for ICSI; 1.51, 1.09 to 2.08, for IVF). Fathers who conceived through ICSI and developed prostate cancer received androgen deprivation therapy to at least the same extent as the reference group (odds ratio 1.91; P=0.07). CONCLUSIONS: Men who achieved fatherhood through assisted reproduction techniques, particularly through ICSI, are at increased risk for early onset prostate cancer and thus constitute a risk group in which testing and careful long term follow-up for prostate cancer may be beneficial.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Fertilização In Vitro/estatística & dados numéricos , Infertilidade Masculina/epidemiologia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/epidemiologia , Adulto , Idade de Início , Estudos de Coortes , Fertilização , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Análise de Sobrevida , Suécia/epidemiologia
14.
Int J Mol Sci ; 20(15)2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31390729

RESUMO

Inflammation is inherent in prostatic diseases and it is now accepted that it may facilitate cellular proliferation in both benign and malignant conditions. The strong relationship between prostatic inflammation and pathogenesis of benign prostatic hyperplasia (BPH) is supported by epidemiologic, histopathologic and molecular evidence. Contrariwise, the role of inflammation in prostate carcinogenesis is still controversial, although current data indicate that the inflammatory microenvironment can regulate prostate cancer (PCa) growth and progression. Knowledge of the complex molecular landscape associated with chronic inflammation in the context of PCa may lead to the introduction and optimization of novel targeted therapies. In this perspective, evaluation of the inflammatory component in prostate specimens could be included in routine pathology reports.


Assuntos
Suscetibilidade a Doenças , Neoplasias da Próstata/etiologia , Prostatite/complicações , Animais , Biomarcadores , Transformação Celular Neoplásica , Progressão da Doença , Humanos , Mediadores da Inflamação , Masculino , Prevalência , Neoplasias da Próstata/epidemiologia , Prostatite/epidemiologia , Prostatite/metabolismo , Prostatite/patologia
15.
Bull Cancer ; 106(10): 868-874, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31350015

RESUMO

OBJECTIVES: To describe the epidemiological, clinical and therapeutic aspects of primary urological cancers in semi-urban areas in Burkina Faso. PATIENTS AND METHOD: A descriptive study was conducted over the period from 1 January 2008 to 31 December 2017 in the General Surgery Department of the Tenkodogo Regional Hospital, located in the east of Burkina Faso. All patients over 15 years of age who were diagnosed with primary urological cancer were included. RESULTS: A total of 160 patients were included. One hundred and thirty-one patients were male (81.9%). The sex ratio was 4.5. The average age of the patients was 58.9 years (standard deviation: 18 years). We found 73 cases of prostate cancers (45.6%), 53 bladder cancers (33.1%), 17 kidney cancers (10.6%), 11 testicular cancers (6.9%) and 6 cancers of the male external genitalia (3.7%). The histological types of prostate cancer were adenocarcinoma (88%) and neuroendocrine carcinoma (12%). Thirty-seven prostate cancers (50.7%) were diagnosed at the T3 stage and 12 others (16.4%) at the T4 stage. Prostate cancer treatment was only medical in 23 patients; surgical treatment was indicated in 50 other patients. The 5-year survival was 85%. Sixteen patients (30.2%) had metastatic bladder cancer at the time of diagnosis. The treatment of vesical cancers has been palliative in 50 cases.


Assuntos
Recursos em Saúde , Neoplasias Urológicas/epidemiologia , Neoplasias Urológicas/terapia , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Burkina Faso/epidemiologia , Países em Desenvolvimento , Neoplasias das Glândulas Endócrinas/epidemiologia , Neoplasias das Glândulas Endócrinas/patologia , Neoplasias das Glândulas Endócrinas/terapia , Feminino , Humanos , Neoplasias Renais/epidemiologia , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Distribuição por Sexo , Taxa de Sobrevida , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia , Neoplasias Urológicas/patologia , Adulto Jovem
16.
BMC Urol ; 19(1): 66, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299962

RESUMO

BACKGROUND: The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer. METHODS: In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0-19, 20-99, 100-999, and ≥ 1000 ng/ml. RESULTS: Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0-19 ng/ml (ref 1), 20-99 ng/ml (OR 1.25, 95% CI 1.01-1.55), 100-999 ng/ml (OR 1.47, 95% CI 1.12-1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11-2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant. CONCLUSION: These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.


Assuntos
Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/psicologia , Estresse Psicológico/sangue , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Estresse Psicológico/epidemiologia , Suécia/epidemiologia
17.
BMJ ; 366: l2408, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292122

RESUMO

OBJECTIVE: To assess the associations between the consumption of sugary drinks (such as sugar sweetened beverages and 100% fruit juices), artificially sweetened beverages, and the risk of cancer. DESIGN: Population based prospective cohort study. SETTING AND PARTICIPANTS: Overall, 101 257 participants aged 18 and over (mean age 42.2, SD 14.4; median follow-up time 5.1 years) from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed by using repeated 24 hour dietary records, which were designed to register participants' usual consumption for 3300 different food and beverage items. MAIN OUTCOME MEASURES: Prospective associations between beverage consumption and the risk of overall, breast, prostate, and colorectal cancer were assessed by multi-adjusted Fine and Gray hazard models, accounting for competing risks. Subdistribution hazard ratios were computed. RESULTS: The consumption of sugary drinks was significantly associated with the risk of overall cancer (n=2193 cases, subdistribution hazard ratio for a 100mL/d increase 1.18, 95% confidence interval 1.10 to 1.27, P<0.0001) and breast cancer (693, 1.22, 1.07 to 1.39, P=0.004). The consumption of artificially sweetened beverages was not associated with the risk of cancer. In specific subanalyses, the consumption of 100% fruit juice was significantly associated with the risk of overall cancer (2193, 1.12, 1.03 to 1.23, P=0.007). CONCLUSIONS: In this large prospective study, the consumption of sugary drinks was positively associated with the risk of overall cancer and breast cancer. 100% fruit juices were also positively associated with the risk of overall cancer. These results need replication in other large scale prospective studies. They suggest that sugary drinks, which are widely consumed in Western countries, might represent a modifiable risk factor for cancer prevention. STUDY REGISTRATION: ClinicalTrials.gov NCT03335644.


Assuntos
Bebidas/efeitos adversos , Sucos de Frutas e Vegetais/efeitos adversos , Neoplasias/epidemiologia , Edulcorantes/efeitos adversos , Neoplasias da Mama/epidemiologia , Neoplasias Colorretais/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Vigilância da População , Modelos de Riscos Proporcionais , Estudos Prospectivos , Neoplasias da Próstata/epidemiologia , Fatores de Risco
18.
Prostate ; 79(12): 1457-1461, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31294484

RESUMO

BACKGROUND: Small cell carcinoma (SCC) of the prostate is a rare, aggressive disease. Evidence is limited; however, the current standard of care is chemotherapy. The benefit of local treatment modalities is unknown. METHODS: We queried the National Cancer Database identifying all SCC/neuroendocrine cases of the prostate, excluding those with unknown nodal or metastatic status, unknown treatment, or those not receiving chemotherapy. Overall survival (OS) was calculated using Kaplan-Meier curves. Multivariable Cox proportional hazards model was used to identify factors associated with survival. A further subgroup analysis was performed on the utility of local therapy on survival in the nonmetastatic setting. RESULTS: Our final cohort included 657 patients with a median age of 68. Most patients had positive lymph nodes (60.1%) and metastatic disease (70.0%). Median survival was 12 months (95% confidence interval [95% CI], 11.1-13.3 months) with a median follow-up of 11.8 months. Metastatic disease, age greater than or equal to 70, omission of androgen deprivation therapy (ADT), and lower income (P < .05 for all) were all associated with reduced OS. Patients with prostate-specific antigen (PSA) greater than or equal to 33 ng/mL and those receiving ADT had better survival (P < .05). Those with nonmetastatic disease were more likely to undergo prostatectomy and/or prostatic/pelvic radiation (P < .0001). Prostatic/pelvic radiation in the nonmetastatic setting was associated with longer survival (P = .02). Though well powered, our study is limited by the selection bias inherent to all observational studies, despite the statistical methods utilized to reduce this effect. CONCLUSIONS: Although chemotherapy is the mainstay of treatment, radiation to the prostate/pelvis may be beneficial in the nonmetastatic setting. In addition to chemotherapy, ADT may benefit patients with an elevated PSA.


Assuntos
Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Pequenas/terapia , Tumores Neuroendócrinos/epidemiologia , Tumores Neuroendócrinos/terapia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Pequenas/mortalidade , Bases de Dados Factuais , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/mortalidade , Neoplasias da Próstata/mortalidade , Resultado do Tratamento , Estados Unidos/epidemiologia
19.
Nutrients ; 11(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315238

RESUMO

An ongoing controversy exists regarding the effect of dairy products on prostate cancer risk in observational studies. We prospectively investigated the associations between dairy product consumption and prostate cancer risk among men in the United States. After calculating pre-diagnostic intake of individual or subgroups of dairy products using a validated food frequency questionnaire, we estimated hazard ratios (HR) and 95% confidence intervals (CI) for pathologically-verified cases of incident prostate cancer among men, overall, or stratified by severity. Among 49,472 men, 4134 were diagnosed with prostate cancer during an average follow-up period of 11.2 years. The median total dairy intake was 101 g/1000 kcal. Consumption of total, individual, or subgroups of dairy products was not statistically significantly associated with prostate cancer risk overall (HR = 1.05, 95% CI = 0.96-1.15 comparing the highest with lowest quartile) or stratified by severity, except for regular-fat dairy product intake with late-stage prostate cancer risk (HR = 1.37, 95% CI = 1.04-1.82 comparing the highest with lowest quartile) and 2%-fat milk intake with advanced prostate cancer risk (HR = 1.14, 95% CI = 1.02-1.28 comparing the higher than median intake with no intake group). Our findings do not support the previously reported harmful impact of dairy consumption on overall prostate cancer risk among men in the United States.


Assuntos
Laticínios , Neoplasias da Próstata/epidemiologia , Idoso , Estudos de Coortes , Comportamento Alimentar , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
20.
Medicine (Baltimore) ; 98(27): e16341, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277188

RESUMO

BACKGROUND: Mediterranean dietary pattern has attracted great attention in terms of its effect on human health. However, whether Mediterranean dietary pattern is an independent protective factor for prostate cancer remains controversial. Our goal was to evaluate this association by conducting a meta-analysis of observational studies. METHODS: We searched the PubMed and EMBASE database through February 2019 for relevant studies that examined the association between Mediterranean Diet and prostate cancer risk. The combined risk estimates were computed using a DerSimonian random-effects model. RESULTS: A total of 10 eligible studies were included in this meta-analysis. The pooled risk estimates and 95% confidence interval (CI) in relation to Mediterranean diet pattern were 0.95 (95% CI: 0.90 to 1.01) for total prostate cancer, 0.93 (95% CI: 0.75 to 1.14) for advanced prostate cancer, 0.96 (95% CI: 0.81 to 1.14) for localized prostate cancer, and 0.92 (95% CI: 0.76 to 1.11) for fatal prostate cancer. There was no evidence of heterogeneity for total (P = .326, I = 12.7%), localized (P = .706, I = 0.0%) and fatal prostate cancer (P = .282, I = 13.0%), but not for advanced prostate cancer (P = .018, I = 63.4%). CONCLUSION: This large meta-analysis of observational studies suggests that Mediterranean dietary pattern has no relationship with prostate cancer risk.


Assuntos
Dieta Mediterrânea , Neoplasias da Próstata/epidemiologia , Humanos , Masculino , Neoplasias da Próstata/patologia , Risco
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