Risk of esophageal and gastric adenocarcinoma in men receiving androgen deprivation therapy for prostate cancer

Abstract

The aim of this study was to explore the male predominance in esophageal and gastric adenocarcinoma by evaluating the preventive potential of androgen deprivation therapy (ADT). This matched cohort study was based on a national Swedish database of prostate cancer patients in 2006–2013. Prostate cancer patients receiving ADT were the exposed group. 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 control group. The participants were followed until a diagnosis of esophageal or gastric cancer, death, emigration, or end of the study period. The risk of esophageal adenocarcinoma, cardia gastric adenocarcinoma, non-cardia gastric adenocarcinoma, and esophageal squamous-cell carcinoma among ADT-exposed compared to unexposed was calculated by multivariable Cox proportional hazard regression. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for confounders. There was a risk reduction of non-cardia gastric adenocarcinoma among ADT-users compared to non-users (HR 0.49 [95% CI 0.24–0.98]). No such decreased risk was found for esophageal adenocarcinoma (HR 1.17 [95% CI 0.60–2.32]), cardia gastric adenocarcinoma (HR 0.99 [95% CI 0.40–2.46]), or esophageal squamous cell carcinoma (HR 0.99 [95% CI 0.31–3.13]). This study indicates that androgen deprivation therapy decreases the risk of non-cardia gastric adenocarcinoma, while no decreased risk was found for esophageal adenocarcinoma, cardia gastric adenocarcinoma, or esophageal squamous-cell carcinoma.

Molecular and clinical analysis of genes involved in gastric cancer

“…Men are generally affected by this disease twice as often as women. Stomach cancer in blacks is twice as much as in whites, with the sex ratio (male to female 2:1) [3]. Gastric cancer can develop in all parts of the stomach.…”

Esophageal Cancer and Sex Hormones

“…2021년 발표된 연구에서는 2006년부터 2013년까지전립선암 환자 database와 matched cohort (출생연도 와 거주지에 따라 무작위로 선정)를 대상으로 하여 항안 드로겐 치료를 받은 전립선암 대조군에서 식도선암, 식도 편평세포암의 발생을 다변수 Cox 비례 위험 회귀 분석 으로 조사하였다[14]. 이 연구에서는 식도선암의 hazard ratio (HR)는 1.17 (95% CI, 0.60-2.32), 식도 편평세포 암의 HR은 0.99 (95% CI, 0.31-3.13)로 식도선암과 식 도 편평세포암의 발생에 차이가 없었다.순환 성호르몬(circulatingsex hormones) 순환 성호르몬을 측정하여 식도암 발생의 연관성을 조 사한 연구들이 최근 발표되었다.…”