Androgens & colorectal cancer

[pca2004]

Interesting new Swedish study below [1]. 

“To assess whether androgens play a role in explaining the sex related differences in the incidence of colorectal cancer (CRC).” 

According to the American Cancer Society: 

“Overall, the lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 26 for women.” 

So men have a greater risk.  If that is related to androgens, perhaps ADT would reduce the risk? 

However, “There was an increased risk of {colorectal cancer} among ADT exposed PC patients compared to unexposed cancer-free men (HR 1.27 …),  

“in particular an increased risk of adenocarcinoma of the colon (HR 1.33 …) and …  

“more specifically an increased risk of adenocarcinoma of the distal colon (HR 1.53 …). 

“Examination of latency effects yielded significantly decreased HRs over time for {colorectal cancer}”

 -Patrick 

[1] pubmed.ncbi.nlm.nih.gov/373... 

Cancer Causes Control·        ·        ·        . 

2023 Jun 21. doi: 10.1007/s10552-023-01736-5. Online ahead of print.

Risk of colorectal adenocarcinoma in men receiving androgen deprivation therapy for prostate cancer; a nationwide cohort study

Richard Shore 1 2, Ji Zhang 3, Weimin Ye 3, Pär Stattin 4, Mats Lindblad 5 6

Affiliations ·       

1department of clinical science, intervention and technology (clintec), karolinska institutet, stockholm, sweden. [e-mail].·       

2function perioperative medicine and intensive care, karolinska university hospital, stockholm, sweden. [e-mail].·       

3department of medical epidemiology and biostatistics (meb), karolinska institutet, stockholm, sweden.·       

4department of surgical sciences, uppsala university, uppsala, sweden.·       

5department of clinical science, intervention and technology (clintec), karolinska institutet, stockholm, sweden.·       

6department of upper abdominal diseases, karolinska university hospital, stockholm, sweden.·       pmid: 37341814 ·       

doi: 10.1007/s10552-023-01736-5

abstract

purpose: to assess whether androgens play a role in explaining the sex related differences in the incidence of colorectal cancer (crc).

methods: a nationwide matched cohort study was conducted employing the prostate cancer data base sweden (pcbase) 4.0 during the study period 2006-2016. prostate cancer (pc) patients receiving androgen deprivation therapy (adt) were treated as exposed. prostate cancer-free men from the general population were randomly selected and matched to the index case by birth year and county of residence, forming the unexposed group. all were followed until a diagnosis of crc, death, emigration, or end of the study period. the risk of crc among adt exposed pc patients compared to unexposed cancer-free men was calculated using a flexible parametric survival model and expressed as hazard ratios (hrs) with 95% confidence intervals (cis).

results: there was an increased risk of crc among adt exposed pc patients compared to unexposed cancer-free men (hr 1.27 [95% ci 1.15-1.41]), in particular an increased risk of adenocarcinoma of the colon (hr 1.33 [95% ci 1.17-1.51]) and more specifically an increased risk of adenocarcinoma of the distal colon (hr 1.53 [95% ci 1.26-1.85]). examination of latency effects yielded significantly decreased hrs over time for crc (p = 0.049 for trend).

conclusions: this population-based study found an increased risk of crc among pc patients exposed to adt, specifically adenocarcinoma of the distal colon, which indicates an increased association between adt (pc + adt) and crc but not a positive dose-response trend questioning a true causal effect.

keywords: adenocarcinoma; androgen antagonists.; colorectal neoplasms; gonadal steroid hormones; prostatic neoplasms.

© 2023. the author(s).