30 results on '"P. Stattin"'
Search Results
2. Spironolactone use is associated with lower risk of prostate cancer
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K. Beckmann, H. Garmo, B. Lindahl, L. Holmberg, P. Stattin, J. Adolfsson, K. Cruickshank, and M. Van Hemelrijck
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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3. Radiotherapy treatment for prostate cancer in Sweden: Patterns over 20 years
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K. Beckmann, H. Garmo, M. Van Hemelrijck, P. Nilsson, I. Franck Lissbrant, and P. Stattin
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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4. Changes in treatment and mortality in men with locally advanced prostate cancer between 2000-2016. Nationwide, population-based study in Sweden
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A.W. Orrason, M. Westerberg, H. Garmo, I.F. Lissbrant, D. Robinson, and P. Stattin
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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5. Radical treatment for high-risk prostate cancer among older men in Sweden according to life expectancy estimates
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K. Beckmann, J. Adolfsson, M. Van Hemelrijck, D. Robinson, P. Stattin, and H. Garmo
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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6. Modeling Disease Trajectories for Castration-resistant Prostate Cancer Using Nationwide Population-based Data
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Eugenio Ventimiglia, Anna Bill-Axelson, Jan Adolfsson, Markus Aly, Martin Eklund, Marcus Westerberg, Pär Stattin, and Hans Garmo
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Castration-resistant prostate cancer ,Survival ,State transition model ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Little is known about disease trajectories for men with castration-resistant prostate cancer (CRPC). Objective: To create a state transition model that estimates time spent in the CRPC state and its outcomes. Design, setting, and participants: The model was generated using population-based prostate-specific antigen data from 40% of the Swedish male population, which were linked to nationwide population-based databases. We compared the observed and predicted cumulative incidence of transitions to and from the CRPC state. Outcome measurements and statistical analysis: We measured time spent in the CRPC state and the proportion of men who died of prostate cancer during follow-up by CRPC risk category. Results and limitations: Time spent in the CRPC state varied from 1.1 yr for the highest risk category to 3.9 yr for the lowest risk category. The proportion of men who died from prostate cancer within 10 yr ranged from 93% for the highest risk category to 54% for the lowest. There was good agreement between the model estimates and observed data. Conclusions: There is large variation in the time spent in the CRPC state, varying from 1 yr to 4 yr according to risk category. Patient summary: It is possible to accurately estimate the disease trajectory and duration for men with castration-resistant prostate cancer.
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- 2022
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7. Changes in treatment and mortality in men with locally advanced prostate cancer between 2000-2016. Nationwide, population-based study in Sweden
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H. Garmo, A.W. Orrason, D. Robinson, Marcus Westerberg, Ingela Franck Lissbrant, and P. Stattin
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Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Locally advanced ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,Population based study ,Prostate cancer ,Internal medicine ,medicine ,business - Published
- 2020
8. Body mass index and risk of over 100 cancer forms and subtypes in 4.1 million individuals in Sweden: the Obesity and Disease Development Sweden (ODDS) pooled cohort studyResearch in context
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Ming Sun, Marisa da Silva, Tone Bjørge, Josef Fritz, Innocent B. Mboya, Mats Jerkeman, Pär Stattin, Jens Wahlström, Karl Michaëlsson, Bethany van Guelpen, Patrik K.E. Magnusson, Sven Sandin, Weiyao Yin, Ylva Trolle Lagerros, Weimin Ye, Bright Nwaru, Hannu Kankaanranta, Lena Lönnberg, Abbas Chabok, Karolin Isaksson, Nancy L. Pedersen, Sölve Elmståhl, Lars Lind, Linnea Hedman, Christel Häggström, and Tanja Stocks
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Obesity ,Body mass index ,Cancer ,Public aspects of medicine ,RA1-1270 - Abstract
Summary: Background: Obesity, assessed by body mass index (BMI), is an established risk factor for 13 cancers. We aimed to identify further potential obesity-related cancers and to quantify their association with BMI relative to that of established obesity-related cancers. Methods: Using Cox regression models on 4,142,349 individuals in Sweden (mean age 27.1 years at weight measurement), we calculated hazard ratios (HRs) for the association between BMI and the risk of 122 cancers and cancer subtypes, grouped by topography and morphology. Cancers with a positive association (i.e., HR >1) at an α-level of 0.05 for obesity (BMI ≥30 kg/m2) vs. normal weight (BMI 18.5–24.9 kg/m2) or per 5 kg/m2 higher BMI, for which obesity is not an established risk factor, were considered potentially obesity related. Findings: After 100.2 million person-years of follow-up, 332,501 incident cancer cases were recorded. We identified 15 cancers in men and 16 in women as potentially obesity related. These were cancers of the head and neck, gastrointestinal tract, malignant melanoma, genital organs, endocrine organs, connective tissue, and haematological malignancies. Among these, there was evidence of differential associations with BMI between subtypes of gastric cancer, small intestine cancer, cervical cancer, and lymphoid neoplasms (P values for heterogeneity in HRs
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- 2024
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9. Palmoplantar keratoderma and digital clubbing in 2 sisters with hypertrophic osteoarthropathy
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Daniel Eriksson, MD, PhD, David Gyll, MD, Marie Virtanen, MD, Niklas Dahl, MD, PhD, Joakim Klar, PhD, and Eva-Lena Stattin, MD, PhD
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digital clubbing ,hereditary palmoplantar keratoderma ,hypertrophic osteoarthropathy ,HPGD ,hyperhidrosis ,Dermatology ,RL1-803 - Published
- 2023
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10. Generation of induced pluripotent stem cells (ARO-iPSC1-11) from a patient with autosomal recessive osteopetrosis harboring the c.212 + 1G > T mutation in SNX10 gene
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Maojia Xu, Eva-lena Stattin, Mary Murphy, and Frank Barry
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Biology (General) ,QH301-705.5 - Abstract
Pathogenic sequence variants in the Sorting Nexin 10 (SNX10) gene have been associated with autosomal recessive osteopetrosis (ARO) in human. In this study, an induced pluripotent stem cell (iPSC) line (ARO-iPSC1-11) was generated from an ARO patient carrying the homozygous c.212 + 1G > T mutation in SNX10, using a retroviral-based reprogramming protocol. Characterization confirmed that the generated iPSCs expressed pluripotency markers, displayed normal karyotype, showed pluripotent differentiation capacity and retained the targeted mutation. Disease modeling with this ARO patient-specific iPSC line will shed further light on the critical role of the SNX10 mutation in ARO development.
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- 2017
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11. Target trial emulation using new comorbidity indices provided risk estimates comparable to a randomized trial.
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Westerberg M, Garmo H, Robinson D, Stattin P, and Gedeborg R
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- Humans, Male, Aged, Sweden epidemiology, Middle Aged, Risk Assessment methods, Benchmarking methods, Prostatic Neoplasms therapy, Prostatic Neoplasms mortality, Prostatic Neoplasms surgery, Comorbidity, Prostatectomy statistics & numerical data, Randomized Controlled Trials as Topic
- Abstract
Objectives: To quantify the ability of two new comorbidity indices to adjust for confounding, by benchmarking a target trial emulation against the randomized controlled trial (RCT) result., Study Design and Setting: Observational study including 18,316 men from Prostate Cancer data Base Sweden 5.0, diagnosed with prostate cancer between 2008 and 2019 and treated with primary radical prostatectomy (RP, n = 14,379) or radiotherapy (RT, n = 3,937). The effect on adjusted risk of death from any cause after adjustment for comorbidity by use of two new comorbidity indices, the multidimensional diagnosis-based comorbidity index and the drug comorbidity index, were compared to adjustment for the Charlson comorbidity index (CCI)., Results: Risk of death was higher after RT than RP (hazard ratio [HR] = 1.94; 95% confidence interval [CI]: 1.70-2.21). The difference decreased when adjusting for age, cancer characteristics, and CCI (HR = 1.32, 95% CI: 1.06-1.66). Adjustment for the two new comorbidity indices further attenuated the difference (HR 1.14, 95% CI 0.91-1.44). Emulation of a hypothetical pragmatic trial where also older men with any type of baseline comorbidity were included, largely confirmed these results (HR 1.10; 95% CI 0.95-1.26)., Conclusion: Adjustment for comorbidity using two new indices provided comparable risk of death from any cause in line with results of a RCT. Similar results were seen in a broader study population, more representative of clinical practice., Competing Interests: Declaration of competing interest There are no competing interests for any author., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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12. Choice of imputation method for missing metastatic status affected estimates of metastatic prostate cancer incidence.
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Westerberg M, Beckmann K, Gedeborg R, Irenaeus S, Holmberg L, Garmo H, and Stattin P
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- Male, Humans, Incidence, Data Collection, Registries, Risk Factors, Prostatic Neoplasms epidemiology
- Abstract
Objectives: To study how handling missing data on M stage in a clinical cancer register affects estimates of incidence of metastatic prostate cancer., Study Design and Setting: Estimates of age-standardized incidence of metastatic prostate cancer were obtained by the use of data in a population-based clinical cancer register in Sweden and using four methods for imputation of missing M stage. Adjusted survival was used to compare men with known and imputed M stage., Results: The proportion of men with missing M stage was high (66%) and varied according to the risk group and over calendar time. The estimated incidence of metastatic disease varied depending on imputation method, with all methods indicating a decreasing incidence over time. A combination of deterministic imputation (DI) and multiple imputation (MI) produced adjusted survival curves for men with imputed M stage that best resembled the survival for men with known M stage., Conclusions: Plausible estimates of incidence of metastatic prostate cancer in clinical cancer registers can be obtained by the use of a combination of DI of missing M stage and MI., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2023
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13. Real World Outcomes in Patients With Metastatic, Castration-Resistant Prostate Cancer Treated With Radium-223 in Routine Clinical Practice in Sweden.
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Stattin P, Westerberg M, Lissbrant IF, Eriksson MH, Kjellman A, Ullén A, Vassilev Z, Sandstrom P, Weinrib R, Martinez D, and Garcia-Albeniz X
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- Male, Humans, Sweden epidemiology, Retrospective Studies, Prostatic Neoplasms, Castration-Resistant drug therapy, Radium therapeutic use, Fractures, Bone chemically induced, Fractures, Bone drug therapy, Bone Neoplasms radiotherapy, Bone Neoplasms drug therapy
- Abstract
Aim: Estimate the effect of Radium-223 (Ra-223) on the incidence of bone fractures, prostate cancer death, and all-cause death compared with other standard treatments for metastatic, castration-resistant prostate cancer (mCRPC)., Methods: Using a cohort design, we estimated the effect of Ra-223 on the risk of bone fractures, all-cause and prostate cancer-specific mortality across different lines of treatment for mCRPC using Prostate Cancer data Base Sweden (2013-2018). The comparator group comprised other standard treatments for mCRPC. We used 36-month risk differences and hazard ratios (HRs) as effect estimates., Results: The number of eligible individuals was 635, 453, 262, and 84 for the first-, second-, third-, and fourth-line cohorts, respectively. When compared Ra-223 to other standard treatments, the difference in the 36-month risk of fracture was 6% (95% confidence interval [CI], -7% to 18%) in the first-line cohort (n = 635) and 8% (95% CI, -7% to 18%) in the second-line cohort (n = 453). The number of fractures in the third-/fourth-line cohorts was too small for an adjusted comparison. The difference in 36-month mortality was higher in the first-line cohort 13% (95% CI, -3% to 31%), but lower in the second- and third-/fourth-line cohorts-8% (95% CI, -23% to 7%) and -14% (95% CI, -21% to 16%) respectively. Most deaths were due to prostate cancer., Conclusion: Results suggest that the difference in the risk of fractures is small, if any. A difference in the risk of mortality may be present in first-line treatment, but a decreased risk of mortality was observed in second and later lines of treatment. The results on mortality need to be considered in the context of potential unmeasured or residual confounding., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2023
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14. Anastomotic leakage after anterior resection in patients with rectal cancer previously irradiated for prostate cancer.
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Sverrisson I, Folkvaljon F, Chabok A, Stattin P, Smedh K, and Nikberg M
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- Aged, Anastomosis, Surgical adverse effects, Anastomotic Leak epidemiology, Humans, Incidence, Male, Middle Aged, Retrospective Studies, Risk Factors, Survival Rate trends, Sweden epidemiology, Anastomotic Leak etiology, Digestive System Surgical Procedures adverse effects, Prostatic Neoplasms radiotherapy, Rectal Neoplasms surgery, Rectum surgery, Registries
- Abstract
Introduction: There are little data on the post-operative outcome of anterior resection (AR) for rectal cancer in men who had received radiotherapy for prostate cancer previously. The aim of this study was to assess the rate of anastomotic leakage (AL) after AR in these patients., Methods: All men who underwent bowel resection because of rectal cancer between 2000 and 2016 and had been diagnosed previously with prostate cancer were identified by linking the Swedish Colorectal Cancer Registry with the National Prostate Cancer Register. The medical records of men who underwent AR and had previously received radiotherapy for prostate cancer were reviewed., Results: In total, 13299 men had undergone a bowel resection for rectal cancer, 188 of whom had previously received radiotherapy for prostate cancer. Among those who had received radiation therapy, 59 men (31%) had an AR: 50 men (85%) received a diverting ileostomy, 42 men (71%) had an American Society of Anesthesiologists score of 1-2 and 36 men (61%) had tumour stage 1-2. AL was found in 12/59 men (20%), one of whom had a re-laparotomy. There was no 90-day mortality., Conclusions: In the combined national population-based registries, a minority of patients with rectal cancer had an AR after previous radiotherapy for prostate cancer. These patients were healthy with early cancer stages and, in this selected group of patients, the AL rate was much lower than that reported previously., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2019
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15. Reply to the letter to the editor 'Age at diagnosis and prognosis among prostate cancer patients treated with radiotherapy: evidenced from three independent cohort studies' by X. Dong, G. Ma and F. Chen.
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Pettersson A, Robinson D, Garmo H, Holmberg L, and Stattin P
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- Cohort Studies, Humans, Male, Prognosis, Prostatectomy, Prostatic Neoplasms
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- 2018
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16. Age at diagnosis and prostate cancer treatment and prognosis: a population-based cohort study.
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Pettersson A, Robinson D, Garmo H, Holmberg L, and Stattin P
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- Age Factors, Aged, Aged, 80 and over, Androgen Antagonists therapeutic use, Antineoplastic Agents therapeutic use, Cohort Studies, Humans, Male, Middle Aged, Proportional Hazards Models, Prostatectomy mortality, Radiotherapy mortality, Sweden epidemiology, Prostatic Neoplasms diagnosis, Prostatic Neoplasms epidemiology, Prostatic Neoplasms therapy
- Abstract
Background: Old age at prostate cancer diagnosis has been associated with poor prognosis in several studies. We aimed to investigate the association between age at diagnosis and prognosis, and if it is independent of tumor characteristics, primary treatment, year of diagnosis, mode of detection and comorbidity., Patients and Methods: We conducted a nation-wide cohort study including 121 392 Swedish men aged 55-95 years in Prostate Cancer data Base Sweden 3.0 diagnosed with prostate cancer in 1998-2012 and followed for prostate cancer death through 2014. Data were available on age, stage, grade, prostate-specific antigen (PSA)-level, mode of detection, comorbidity, educational level and primary treatment. We used Cox regression to calculate hazard ratios (HRs) and 95% confidence intervals (CIs)., Results: With increasing age at diagnosis, men had more comorbidity, fewer PSA-detected cancers, more advanced cancers and were less often treated with curative intent. Among men with high-risk or regionally metastatic disease, the proportion of men with unknown M stage was higher among old men versus young men. During a follow-up of 751 000 person-years, 23 649 men died of prostate cancer. In multivariable Cox-regression analyses stratified by treatment, old age at diagnosis was associated with poorer prognosis among men treated with deferred treatment (HRage 85+ versus 60-64: 7.19; 95% CI: 5.61-9.20), androgen deprivation therapy (HRage 85+ versus 60-64: 1.72; 95% CI: 1.61-1.84) or radical prostatectomy (HRage 75+ versus 60-64: 2.20; 95% CI: 1.01-4.77), but not radiotherapy (HRage 75+ versus 60-64: 1.08; 95% CI: 0.76-1.53)., Conclusion: Our findings argue against a strong inherent effect of age on risk of prostate cancer death, but indicate that in current clinical practice, old men with prostate cancer receive insufficient diagnostic workup and subsequent curative treatment., (© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2018
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17. International cancer seminars: a focus on kidney cancer.
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Scelo G, Hofmann JN, Banks RE, Bigot P, Bhatt RS, Cancel-Tassin G, Chew SK, Creighton CJ, Cussenot O, Davis IJ, Escudier B, Frayling TM, Häggström C, Hildebrandt MA, Holcatova I, Johansson M, Linehan WM, McDermott DF, Nathanson KL, Ogawa S, Perlman EJ, Purdue MP, Stattin P, Swanton C, Vasudev NS, Wu X, Znaor A, Brennan P, and Chanock SJ
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- Biomedical Research, Humans, Kidney Neoplasms etiology, Kidney Neoplasms pathology, Genomics, Kidney Neoplasms genetics
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Recent years have seen important advances in our understanding of the etiology, biology and genetics of kidney cancer. To summarize important achievements and identify prominent research questions that remain, a workshop was organized by IARC and the US NCI. A series of 'difficult questions' were formulated, which should be given future priority in the areas of population, genomic and clinical research., (© The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2016
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18. Fatty acid patterns and risk of prostate cancer in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition.
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Dahm CC, Gorst-Rasmussen A, Crowe FL, Roswall N, Tjønneland A, Drogan D, Boeing H, Teucher B, Kaaks R, Adarakis G, Zylis D, Trichopoulou A, Fedirko V, Chajes V, Jenab M, Palli D, Pala V, Tumino R, Ricceri F, van Kranen H, Bueno-de-Mesquita HB, Quirós JR, Sánchez MJ, Luján-Barroso L, Larrañaga N, Chirlaque MD, Ardanaz E, Johansson M, Stattin P, Khaw KT, Wareham N, Wark PA, Norat T, Riboli E, Key TJ, and Overvad K
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- Aged, Algorithms, Case-Control Studies, Cohort Studies, Europe epidemiology, Fatty Acids adverse effects, Fatty Acids metabolism, Fatty Acids, Omega-3 adverse effects, Fatty Acids, Omega-3 blood, Fatty Acids, Omega-3 metabolism, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Neoplasm Grading, Phospholipids chemistry, Prospective Studies, Prostatic Neoplasms epidemiology, Prostatic Neoplasms etiology, Prostatic Neoplasms pathology, Risk, Statistics as Topic, Surveys and Questionnaires, Fatty Acids blood, Phospholipids blood, Prostatic Neoplasms blood
- Abstract
Background: Fatty acids in blood may be related to the risk of prostate cancer, but epidemiologic evidence is inconsistent. Blood fatty acids are correlated through shared food sources and common endogenous desaturation and elongation pathways. Studies of individual fatty acids cannot take this into account, but pattern analysis can. Treelet transform (TT) is a novel method that uses data correlation structures to derive sparse factors that explain variation., Objective: The objective was to gain further insight in the association between plasma fatty acids and risk of prostate cancer by applying TT to take data correlations into account., Design: We reanalyzed previously published data from a case-control study of prostate cancer nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. TT was used to derive factors explaining the variation in 26 plasma phospholipid fatty acids of 962 incident prostate cancer cases matched to 1061 controls. Multiple imputation was used to deal with missing data in covariates. ORs of prostate cancer according to factor scores were determined by using multivariable conditional logistic regression., Results: Four simple factors explained 38% of the variation in plasma fatty acids. A high score on a factor reflecting a long-chain n-3 PUFA pattern was associated with greater risk of prostate cancer (OR for highest compared with lowest quintile: 1.36; 95% CI: 0.99, 1.86; P-trend = 0.041)., Conclusion: Pattern analyses using TT groupings of correlated fatty acids indicate that intake or metabolism of long-chain n-3 PUFAs may be relevant to prostate cancer etiology.
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- 2012
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19. Prostate cancer increases hyaluronan in surrounding nonmalignant stroma, and this response is associated with tumor growth and an unfavorable outcome.
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Josefsson A, Adamo H, Hammarsten P, Granfors T, Stattin P, Egevad L, Laurent AE, Wikström P, and Bergh A
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- Aged, Aged, 80 and over, Animals, Biomarkers, Tumor metabolism, Cell Proliferation, Glucuronosyltransferase metabolism, Humans, Hyaluronan Synthases, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, Prostate metabolism, Prostate pathology, Prostatic Neoplasms enzymology, Rats, Staining and Labeling, Stromal Cells metabolism, Stromal Cells pathology, Treatment Outcome, Watchful Waiting, Hyaluronic Acid metabolism, Prostatic Neoplasms metabolism, Prostatic Neoplasms pathology
- Abstract
Our objective was to investigate whether the presence of a tumor increases hyaluronan (HA) levels in surrounding prostate tissues and whether this extratumoral HA influences tumor growth and outcome. From a series of 287 men diagnosed with prostate cancer at transurethral resection and followed up with watchful waiting, tissue microarrays were constructed, stained, and scored for HA. A high HA staining score in the tumor stroma or in nonmalignant prostate tissue stroma were both associated positively with higher Gleason score and larger tumor volume, and was associated with a poor outcome. HA staining score was not an independent marker for outcome (multivariate Cox, with Gleason score, tumor volume, stage, and HA variables). In an orthotopic rat prostate cancer model, hyaluronic acid synthase-1 mRNA levels and HA staining were increased in normal prostate tissue surrounding prostate cancer. Orthotopic prostate cancer growth was increased by intraprostatic injection of HA. In conclusion, cancer in the prostate apparently stimulates HA synthesis both in tumor stroma and in the surrounding normal tissue. This promoted tumor growth and was associated with an unfavorable outcome., (Copyright © 2011 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.)
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- 2011
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20. Metabolic syndrome and rare gynecological cancers in the metabolic syndrome and cancer project (Me-Can).
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Nagel G, Concin H, Bjørge T, Rapp K, Manjer J, Hallmans G, Diem G, Häggström C, Engeland A, Almquist M, Jonsson H, Selmer R, Stocks T, Tretli S, Ulmer H, Stattin P, and Lukanova A
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- Adult, Aged, Aged, 80 and over, Blood Glucose, Blood Pressure, Body Mass Index, Cholesterol blood, Female, Genital Neoplasms, Female complications, Humans, Metabolic Syndrome blood, Metabolic Syndrome complications, Middle Aged, Proportional Hazards Models, Risk Factors, Triglycerides blood, Genital Neoplasms, Female epidemiology, Metabolic Syndrome epidemiology
- Abstract
Background: Risk factors for rare gynecological cancers are largely unknown. Initial research has indicated that the metabolic syndrome (MetS) or individual components could play a role., Materials and Methods: The Metabolic syndrome and Cancer project cohort includes 288,834 women. During an average follow-up of 11 years, 82 vulvar, 26 vaginal and 43 other rare gynecological cancers were identified. Hazard ratios (HRs) were estimated fitting Cox proportional hazards regression models for tertiles and standardized z-scores [with a mean of 0 and a standard deviation (SD) of 1] of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and MetS. Risk estimates were corrected for random error in the measurement of metabolic factors., Results: The MetS was associated with increased risk of vulvar [HR 1.78, 95% confidence interval (CI) 1.30-2.41) and vaginal cancer (HR 1.87, 95% CI 1.07-3.25). Among separate MetS components, 1 SD increase in BMI was associated with overall risk (HR 1.43, 95% CI 1.23-1.66), vulvar (HR 1.36, 95% CI 1.11-1.69) and vaginal cancer (HR 1.79, 95% CI 1.30-2.46). Blood glucose and triglyceride concentrations were associated with increased risk of vulvar cancer (HR 1.98, 95% CI 1.10-3.58 and HR 2.09, 95% CI 1.39-3.15, respectively)., Conclusion: The results from this first prospective study on rare gynecological cancers suggest that the MetS and its individual components may play a role in the development of these tumors.
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- 2011
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21. Dietary supplement use patterns in men with prostate cancer: the Cancer Prostate Sweden study.
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Westerlund A, Steineck G, Bälter K, Stattin P, Grönberg H, and Hedelin M
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- Aged, Complementary Therapies statistics & numerical data, Feeding Behavior, Humans, Life Style, Male, Middle Aged, Surveys and Questionnaires, Sweden epidemiology, Dietary Supplements, Prostatic Neoplasms epidemiology
- Abstract
Background: In a European setting, we know little about the use of dietary supplements among men with prostate cancer (PCa) and to what extent lifestyle, disease or other factors influence such use., Patients and Methods: We evaluated supplement use in 1127 men with incident PCa and in 900 population controls in Sweden. Age-adjusted binary regression with an identity link was carried out to estimate prevalence differences and corresponding 95% confidence intervals (CIs). Modifying effects of lifestyle- and diet-related factors were explored by statistical assessment of additive interaction., Results: Among men with PCa, 542 individuals (48%) had used supplements, which was a 10% (95% CI: 5.9%-15%) higher prevalence than among population controls. Among individuals with high intake of fatty fish, vegetables, and phytoestrogens, but low intake of saturated fat, supplement use was 29% (95% CI: 18%-41%) more common in men with PCa than in population controls. We found no evidence of heterogeneity by categories of education, smoking history, body mass index, fiber, fruit, or phytoestrogen intake, treatment, or disease stage., Conclusion: Supplement use is common in Swedish men with PCa, especially among those with a healthy dietary pattern., (© The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology.)
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- 2011
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22. Mast cells are novel independent prognostic markers in prostate cancer and represent a target for therapy.
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Johansson A, Rudolfsson S, Hammarsten P, Halin S, Pietras K, Jones J, Stattin P, Egevad L, Granfors T, Wikström P, and Bergh A
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- Animals, Castration, Cells, Cultured, Fibroblast Growth Factor 2 genetics, Fibroblast Growth Factor 2 metabolism, Humans, Male, Neovascularization, Pathologic, Prostatic Neoplasms pathology, Rats, Treatment Outcome, Biomarkers, Tumor metabolism, Mast Cells metabolism, Prostatic Neoplasms metabolism, Prostatic Neoplasms surgery
- Abstract
Mast cells affect growth in various human tumors, but their role in prostate cancer (PC) is unclear. Here, we identify mast cells as independent prognostic markers in PC using a large cohort of untreated PC patients with a long follow-up. By analyzing mast cells in different tissue compartments, our data indicate that intratumoral and peritumoral mast cells have anti- opposed to protumor properties. Intratumoral mast cells negatively regulate angiogenesis and tumor growth, whereas peritumoral mast cells stimulate the expansion of human prostate tumors. We also observed mast cell recruitment particularly to the peritumoral compartment in men during the formation of castrate-resistant prostate tumors. In our ortothopic rat model, mast cells accumulated in the peritumoral tissue where they enhanced angiogenesis and tumor growth. In line with this, prostate mast cells expressed high levels of the angiogenic factor FGF-2. Similar to the situation in men, mast cells infiltrated rat prostate tumors that relapsed after initially effective castration treatment, concurrent with a second wave of angiogenesis and an up-regulation of FGF-2. We conclude that mast cells are novel independent prognostic markers in PC and affect tumor progression in animals and patients. In addition, peritumoral mast cells provide FGF-2 to the tumor micro environment, which may contribute to their stimulating effect on angiogenesis.
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- 2010
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23. Plasma selenium concentration and prostate cancer risk: results from the European Prospective Investigation into Cancer and Nutrition (EPIC).
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Allen NE, Appleby PN, Roddam AW, Tjønneland A, Johnsen NF, Overvad K, Boeing H, Weikert S, Kaaks R, Linseisen J, Trichopoulou A, Misirli G, Trichopoulos D, Sacerdote C, Grioni S, Palli D, Tumino R, Bueno-de-Mesquita HB, Kiemeney LA, Barricarte A, Larrañaga N, Sánchez MJ, Agudo A, Tormo MJ, Rodriguez L, Stattin P, Hallmans G, Bingham S, Khaw KT, Slimani N, Rinaldi S, Boffetta P, Riboli E, and Key TJ
- Subjects
- Aged, Antioxidants metabolism, Case-Control Studies, Cohort Studies, Europe epidemiology, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prostatic Neoplasms pathology, Risk Factors, Smoking adverse effects, alpha-Tocopherol blood, gamma-Tocopherol blood, Antioxidants administration & dosage, Prostatic Neoplasms blood, Prostatic Neoplasms epidemiology, Selenium administration & dosage, Selenium blood
- Abstract
Background: Some evidence indicates that a low selenium intake may be associated with an increased risk of prostate cancer., Objective: The aim of this study was to investigate the association of plasma selenium concentration with subsequent prostate cancer risk and to examine this association by stage and grade of disease and other factors., Design: A nested case-control study was performed among men in the European Prospective Investigation into Cancer and Nutrition (EPIC). The association between plasma selenium concentration and prostate cancer risk was assessed in 959 men with incident prostate cancer and 1059 matched controls., Results: Overall, plasma selenium concentration was not associated with prostate cancer risk; the multivariate relative risk for men in the highest fifth of selenium concentration compared with the lowest fifth was 0.96 (95% CI: 0.70, 1.31; P for trend = 0.25). There were no significant differences in the association of plasma selenium with risk when analyzed by stage or grade of disease. Similarly, the association of selenium with risk did not differ by smoking status or by plasma alpha- or gamma-tocopherol concentration., Conclusion: Plasma selenium concentration was not associated with prostate cancer risk in this large cohort of European men.
- Published
- 2008
- Full Text
- View/download PDF
24. Fatty acid composition of plasma phospholipids and risk of prostate cancer in a case-control analysis nested within the European Prospective Investigation into Cancer and Nutrition.
- Author
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Crowe FL, Allen NE, Appleby PN, Overvad K, Aardestrup IV, Johnsen NF, Tjønneland A, Linseisen J, Kaaks R, Boeing H, Kröger J, Trichopoulou A, Zavitsanou A, Trichopoulos D, Sacerdote C, Palli D, Tumino R, Agnoli C, Kiemeney LA, Bueno-de-Mesquita HB, Chirlaque MD, Ardanaz E, Larrañaga N, Quirós JR, Sánchez MJ, González CA, Stattin P, Hallmans G, Bingham S, Khaw KT, Rinaldi S, Slimani N, Jenab M, Riboli E, and Key TJ
- Subjects
- Case-Control Studies, Chromatography, Gas methods, Confounding Factors, Epidemiologic, Europe epidemiology, Fatty Acids, Unsaturated blood, Follow-Up Studies, Humans, Life Style, Logistic Models, Male, Middle Aged, Neoplasm Staging, Odds Ratio, Palmitic Acid analysis, Prostatic Neoplasms etiology, Prostatic Neoplasms pathology, Risk Factors, Stearic Acids analysis, Diet, Fatty Acids analysis, Phospholipids blood, Prostatic Neoplasms blood, Prostatic Neoplasms epidemiology
- Abstract
Background: Plausible biological mechanisms underlie possible associations between fatty acids in blood and risk of prostate cancer; epidemiologic evidence for an association, however, is inconsistent., Objective: The objectives were to assess the association between plasma phospholipid fatty acids and risk of total prostate cancer by stage and grade., Design: This was a nested case-control analysis of 962 men with a diagnosis of prostate cancer after a median follow-up time of 4.2 y and 1061 matched controls who were taking part in the European Prospective Investigation into Cancer and Nutrition. The fatty acid composition of plasma phospholipids was measured by gas chromatography, and the risk of prostate cancer was estimated by using conditional logistic regression with adjustment for lifestyle variables., Results: We found a positive association between palmitic acid and risk of total, localized, and low-grade prostate cancer. The risk of prostate cancer for men in the highest quintile compared with the lowest quintile of palmitic acid was 1.47 (95% CI: 0.97, 2.23; P for trend = 0.032). We found an inverse association between stearic acid and the risk of total, localized, and low-grade prostate cancer; men in the highest quintile of stearic acid had a relative risk of 0.77 (95% CI: 0.56, 1.06; P for trend = 0.03). There were significant positive associations between myristic, alpha-linolenic, and eicosapentaenoic acids and risk of high-grade prostate cancer., Conclusion: The associations between palmitic, stearic, myristic, alpha-linolenic, and eicosapentaenoic acids and prostate cancer risk may reflect differences in intake or metabolism of these fatty acids between the precancer cases and controls and should be explored further.
- Published
- 2008
- Full Text
- View/download PDF
25. Androgens and prostate cancer risk.
- Author
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Wirén S and Stattin P
- Subjects
- Androgens blood, Enzyme Inhibitors therapeutic use, Finasteride therapeutic use, Humans, Male, Prostatic Neoplasms blood, Prostatic Neoplasms prevention & control, Androgens metabolism, Prostatic Neoplasms metabolism
- Abstract
Androgens have been implicated in prostate tumourigenesis. However, no association between circulating levels of androgens and prostate cancer risk was found in a recent large pooled analysis of prospective studies. A decreased risk of prostate cancer among men treated with finasteride, a 5 alpha-reductase inhibitor which reduces levels of dihydrotestosterone, was observed in the Prostate Cancer Prevention Trial (PCPT), a large clinical trial. In the PCPT, a higher number of high-grade tumours was found in the finasteride group than in the control group; the reason for this finding is still unclear. Treatment of symptoms of late-onset hypogonadism - such as decreased muscle and bone mass and decreased cognition and libido - has become more prevalent with the advent of new forms of administration of testosterone replacement therapy. One small placebo-controlled study showed no increase in incidence of prostate cancer after 6 months of testosterone therapy, but data on the safety of testosterone replacement therapy remain limited.
- Published
- 2008
- Full Text
- View/download PDF
26. Dietary fat intake and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition.
- Author
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Crowe FL, Key TJ, Appleby PN, Travis RC, Overvad K, Jakobsen MU, Johnsen NF, Tjønneland A, Linseisen J, Rohrmann S, Boeing H, Pischon T, Trichopoulou A, Lagiou P, Trichopoulos D, Sacerdote C, Palli D, Tumino R, Krogh V, Bueno-de-Mesquita HB, Kiemeney LA, Chirlaque MD, Ardanaz E, Sánchez MJ, Larrañaga N, González CA, Quirós JR, Manjer J, Wirfält E, Stattin P, Hallmans G, Khaw KT, Bingham S, Ferrari P, Slimani N, Jenab M, and Riboli E
- Subjects
- Aged, Dairy Products, Dietary Fats, Unsaturated administration & dosage, Dietary Fats, Unsaturated adverse effects, Europe epidemiology, Humans, Male, Meat adverse effects, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Prostatic Neoplasms etiology, Risk Factors, Seafood, Surveys and Questionnaires, Dietary Fats administration & dosage, Dietary Fats adverse effects, Feeding Behavior, Prostatic Neoplasms epidemiology
- Abstract
Background: Findings from early observational studies have suggested that the intake of dietary fat might be a contributing factor in the etiology of prostate cancer. However, the results from more recent prospective studies do not support this hypothesis, and the possible association between different food sources of fat and prostate cancer risk also remains unclear., Objective: The objectives were to assess whether intakes of dietary fat, subtypes of fat, and fat from animal products were associated with prostate cancer risk., Design: This was a multicenter prospective study of 142,520 men in the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary fat intake was estimated with the use of country-specific validated food questionnaires. The association between dietary fat and risk of prostate cancer was assessed by using Cox regression, stratified by recruitment center and adjusted for height, weight, smoking, education, marital status, and energy intake., Results: After a median follow-up time of 8.7 y, prostate cancer was diagnosed in 2727 men. There was no significant association between dietary fat (total, saturated, monounsaturated, and polyunsaturated fat and the ratio of polyunsaturated to saturated fat) and risk of prostate cancer. The hazard ratio for prostate cancer for the highest versus the lowest quintile of total fat intake was 0.96 (95% CI: 0.84, 1.09; P for trend = 0.155). There were no significant associations between prostate cancer risk and fat from red meat, dairy products, and fish., Conclusion: The results from this large multicenter study suggest that there is no association between dietary fat and prostate cancer risk.
- Published
- 2008
- Full Text
- View/download PDF
27. Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study.
- Author
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Key TJ, Appleby PN, Allen NE, Travis RC, Roddam AW, Jenab M, Egevad L, Tjønneland A, Johnsen NF, Overvad K, Linseisen J, Rohrmann S, Boeing H, Pischon T, Psaltopoulou T, Trichopoulou A, Trichopoulos D, Palli D, Vineis P, Tumino R, Berrino F, Kiemeney L, Bueno-de-Mesquita HB, Quirós JR, González CA, Martinez C, Larrañaga N, Chirlaque MD, Ardanaz E, Stattin P, Hallmans G, Khaw KT, Bingham S, Slimani N, Ferrari P, Rinaldi S, and Riboli E
- Subjects
- Carotenoids administration & dosage, Case-Control Studies, Cohort Studies, Diet, Europe epidemiology, Follow-Up Studies, Humans, Incidence, Logistic Models, Male, Middle Aged, Neoplasm Staging, Prospective Studies, Prostatic Neoplasms pathology, Risk Factors, Severity of Illness Index, Tocopherols administration & dosage, Vitamin A administration & dosage, Carotenoids blood, Prostatic Neoplasms blood, Prostatic Neoplasms epidemiology, Tocopherols blood, Vitamin A blood
- Abstract
Background: Previous studies suggest that high plasma concentrations of carotenoids, retinol, or tocopherols may reduce the risk of prostate cancer., Objective: We aimed to examine the associations between plasma concentrations of 7 carotenoids, retinol, alpha-tocopherol, and gamma-tocopherol and prostate cancer risk., Design: A total of 137,001 men in 8 European countries participated. After a mean of 6 y, 966 incident cases of prostate cancer with plasma were available. A total of 1064 control subjects were selected and were matched for study center, age, and date of recruitment. The relative risk of prostate cancer was estimated by conditional logistic regression, which was adjusted for smoking status, alcohol intake, body mass index, marital status, physical activity, and education level., Results: Overall, none of the micronutrients examined were significantly associated with prostate cancer risk. For lycopene and the sum of carotenoids, there was evidence of heterogeneity between the associations with risks of localized and advanced disease. These carotenoids were not associated with the risk of localized disease but were inversely associated with the risk of advanced disease. The risk of advanced disease for men in the highest fifth of plasma concentrations compared with men in the lowest fifth was 0.40 (95% CI: 0.19, 0.88) for lycopene and 0.35 (95% CI: 0.17, 0.78) for the sum of carotenoids., Conclusions: We observed no associations between plasma concentrations of carotenoids, retinol, or tocopherols and overall prostate cancer risk. The inverse associations of lycopene and the sum of carotenoids with the risk of advanced disease may involve a protective effect, an association of dietary choice with delayed detection of prostate cancer, reverse causality, or other factors.
- Published
- 2007
- Full Text
- View/download PDF
28. A potential inverse association between insulin-like growth factor I and hypertension in a cross-sectional study.
- Author
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Hunt KJ, Lukanova A, Rinaldi S, Lundin E, Norat T, Palmqvist R, Stattin P, Riboli E, Hallmans G, and Kaaks R
- Subjects
- Adult, Blood Glucose, Blood Pressure, Body Mass Index, Cholesterol blood, Cross-Sectional Studies, Fasting blood, Female, Humans, Hypertension blood, Hypertension etiology, Insulin blood, Insulin-Like Growth Factor Binding Proteins blood, Male, Middle Aged, Models, Statistical, Odds Ratio, Risk Factors, Sweden epidemiology, Hypertension epidemiology, Insulin-Like Growth Factor I analysis
- Abstract
Purpose: Elevated circulating insulin-like growth factor I (IGF-I) levels increasingly are being implicated as a potential risk factor for the development of some cancers; however, relatively few epidemiologic studies have focused on potential relationships between circulating IGF-I levels and cardiovascular risk factors or cardiovascular disease. Hence, our objective is to examine relationships between IGF-I levels; body mass index (BMI); fasting insulin level; IGF binding protein 1 (IGFBP-1), IGFBP-2, and IGFBP-3 levels; and an array of traditional cardiovascular risk factors., Methods: Our analysis included 715 men and women aged 30 to 62 years who participated in the Västerbotten Intervention Project cohort. IGF-I and IGFBP-1, -2, and -3 were measured in stored plasma samples. Cardiovascular risk factors of interest included glucose level (fasting and 2-hour postload), lipid levels (total cholesterol, high-density lipoprotein cholesterol, and triglycerides), blood pressure (systolic and diastolic), and hypertension status. All presented results were adjusted for age, sex, and laboratory batch., Results: IGF-I quartile was associated inversely with 2-hour glucose level and diastolic blood pressure. There was a stepwise inverse graded association between increasing IGF-I quartile and hypertension, with an odds ratio of 0.51 (95% confidence interval, 0.29-0.90) for hypertension comparing the fourth IGF-I quartile with the first. Further adjusting for BMI and IGFBP-3 level simultaneously strengthened the inverse association, with an odds ratio of 0.42 (95% confidence interval, 0.22-0.80) for hypertension comparing the fourth with the first IGF-I quartile., Conclusions: Contrary to positive associations between IGF-I levels and some cancers, our results suggest that IGF-I level may be related inversely to prevalent hypertension, a risk factor for cardiovascular disease.
- Published
- 2006
- Full Text
- View/download PDF
29. Prostate cancer screening.
- Author
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Stattin P, Stenman UH, Riboli E, Hallmans G, and Kaaks R
- Subjects
- Humans, Insulin-Like Growth Factor Binding Protein 3 blood, Insulin-Like Growth Factor I analysis, Male, Prostate-Specific Antigen blood, Prostatic Neoplasms blood, Sensitivity and Specificity, Mass Screening methods, Prostatic Neoplasms diagnosis
- Published
- 2001
- Full Text
- View/download PDF
30. Castration therapy rapidly induces apoptosis in a minority and decreases cell proliferation in a majority of human prostatic tumors.
- Author
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Westin P, Stattin P, Damber JE, and Bergh A
- Subjects
- Genetic Techniques, Humans, Image Processing, Computer-Assisted, Immunoenzyme Techniques, Ki-67 Antigen, Male, Neoplasm Proteins immunology, Nuclear Proteins immunology, Proto-Oncogene Proteins analysis, Proto-Oncogene Proteins c-bcl-2, Proto-Oncogene Proteins c-myc analysis, Tumor Suppressor Protein p53 analysis, Apoptosis physiology, Castration statistics & numerical data, Cell Division physiology, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy
- Abstract
Major differences in the long-term clinical response to castration therapy of prostatic carcinoma suggests intertumoral differences in cellular response and defines a need for identification of patients with an eventually positive outcome as well as those in need of additional treatment. Using morphometry, monoclonal antibodies against Bcl-2, c-myc, Ki-67, and p53 proteins, and an in situ method to visualize apoptotic cells, we examined the short-term response of prostatic tumors to castration in core biopsies from 18 prostatic cancer patients taken the day before and 7 days after castration. At the histological level, 3 tumors seemed practically unaffected by castration. In 15 tumors, castration induced vacuolization of tumor cell cytoplasm and decreases in nuclear area and Ki-67 index. In these 15 tumors, apoptotic index was significantly increased in 6, principally unaffected in 6, and decreased in 3. The 6 tumors responding with an increase in apoptotic index were WHO grade 1 or 2 and negative for p53, c-myc, and Bcl-2 or contained only few Bcl-2- or c-myc-positive tumor cells before therapy. The 12 tumors in which apoptotic index was unaffected or decreased were WHO grade 2 or 3 and immunopositive for one or more of p53, Bcl-2, and c-myc proteins before therapy. The Bcl-2 index was significantly increased in 10 patients. Prostatic tumors may respond in a variety of possibly predictable ways to castration therapy including a decrease in apoptotic index. The magnitude of these responses are not correlated in individual tumors, suggesting that the common classification of prostatic tumors as either androgen dependent (dying after castration) or independent (not responding at all to castration) may be an oversimplification.
- Published
- 1995
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