Bladder Cancer Risk Not Lowered With Androgen Deprivation
In a study, men with prostate cancer who received androgen deprivation therapy did not have a lower subsequent risk of developing bladder cancer.
Previous research documented the presence of androgen receptors in the bladder wall, prompting speculation that androgens may explain, at least in part, why bladder cancer is more common in men than women and that bladder cancer might be prevented with androgen deprivation therapy (ADT). A new study, however, found no evidence to support such a hypothesis.
The study by Marco Moschini, MD, PhD, of Luzerner Kantonsspital, Luzern, Switzerland, and colleagues, included 196,914 men diagnosed with localized prostate cancer (PCa) from 2000 to 2009. Of these, 68,421 (34.7%) received ADT. During a median follow-up of 59 months, bladder cancer developed in 2495 men (1.3%). The 10-year cumulative incidence rate of bladder cancer was 1.75% in the ADT arm and 1.99% in the no-ADT arm. In multivariable analysis, ADT use was not significantly associated with future bladder cancer risk after adjusting for the risk of death from any cause.
The authors concluded that their study found no direct relationship between ADT use and risk of developing bladder cancer. Until definitive conclusions can be reached as to whether patients with bladder cancer may benefit from ADT, the use of ADT outside guideline recommendations for PCa should not be encouraged, they noted.
Dr Moschini and his collaborators identified their study population using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. The median age was 72 years overall, but was significantly higher among men who received ADT than those who did not (75 vs 71 years).
Moschini M, Zaffuto E, Karakiewicz P, et al. The effect of androgen deprivation treatment on subsequent risk of bladder cancer diagnosis in male patients treated for prostate cancer. World J Urol. 2018; published online ahead of print.