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Diabetes not higher risk for prostate cancer, not higher risk for higher grade disease

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Jim Marshall (not a doctor) said ...

When researchers tried to find out whether or not diabetes was linked to getting prostate cancer, or to higher grade prostate cancer, there was a problem.

Diabetes was known to reduce PSA in the blood.

Being overweight was also known to reduce PSA in the blood, and many diabetics are also obese.

So the problem was that, often with lower PSA in the blood, diabetics may not have had so many biopsies, and prostate cancer might have been missed.

The solution found by Wu and colleagues - the REDUCE trial.

The REDUCE trial was designed to find out whether dutasteride (Avodart) would help prevent prostate cancer.

In that trial of more than 8000 men, half were given dutasteride (Avodart), and half were given a dummy pill that looked identical.

The big thing for diabetic-prostate cancer research was that every man in the trial had a biopsy, whether his PSA rose or not.

So no diabetic or obese man would miss out because of lower blood PSA.

And the results for diabetic men?

No greater risk of prostate cancer.

No greater risk of high grade disease.

... end Jim

From Medscape News Today:

In summary, in the REDUCE trial, when all men undergo biopsy regardless of serum PSA, diabetes was not associated with lower PCa risk, but rather equal risk of PCa overall and equal risk of low- and high-grade disease. Our findings suggest that lower rates of PCa previously observed in diabetics may stem, at least in part, from lower serum PSA leading to fewer biopsies and less frequent detection of disease. However, other explanations for these findings exist. Thus, additional studies are needed to confirm our results and clarify the degree, if any, to which lower serum PSA obscures PCa incidence in diabetic men. Our results also add to the limited body of literature examining the interplay between obesity, diabetes and PCa by suggesting that BMI may modify the effect of diabetes on risk of high-grade PCa. Given that many diabetic men are also obese, this is an important relationship that warrants further investigation.

You can read the full article in Medscape News Today here:

Diabetes and Prostate Cancer Risk in the REDUCE Trial

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