Lower Prostate Cancer Risk in Diabetics Likely Due to Fewer Biopsies, Not Medications, Study Says

Lower Prostate Cancer Risk in Diabetics Likely Due to Fewer Biopsies, Not Medications, Study Says
Common treatments for diabetes don't appear to mask or reduce levels of a prostate cancer marker in the blood. Rather, the lower rates of prostate cancer detected in men with diabetes might be because they are less likely to undergo prostate biopsies, a large population-based study from Sweden suggests. The study, "Association Between Antidiabetic Medications and Prostate-Specific Antigen Levels and Biopsy Results," was published in JAMA Network Open. It is well-documented that people with diabetes have a lower rate of prostate cancer diagnoses, but the reasons for this are unclear. Researchers debate whether this is because people with diabetes actually get cancer less often, or if they are just diagnosed less frequently. One idea proposed is that medications used to treat diabetes might lower blood levels of prostate specific antigen (PSA). PSA is often tested as a marker for prostate cancer — elevated levels of this protein are considered a sign of possible cancer — prompting biopsies to confirm a diagnosis. Men with low PSA levels have little reason to undergo a prostate biopsy. To test this idea, researchers analyzed data from the Stockholm PSA and Biopsy Register, which collects data on people undergoing PSA tests and prostate biopsies in Sweden. They identified individuals who were treated with the diabetes medications metformin (4,583 men), sulfonylurea (1,104), or insulin (987 men). Collectively, these people were referred to as the "exposed" group, referring to exposure to a medication. They were then age-matched with people in the database who had no record of using these medications, and who served as an "unexposed" group. On average, PSA levels were lower in the exposed than in the unexposed group before the first recorded prescriptio
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