The risk of new-onset type 2 diabetes and the influence of risk factors among men with prostate cancer in the Danish Diet, Cancer, and Health study.

purposeTo investigate the risk of new-onset type 2 diabetes mellitus (T2DM) in men with and without prostate cancer (PCa) and the influence of cardiometabolic risk factors. Furthermore, we examined the association between first-line androgen deprivation therapy (ADT) and the risk of T2DM in a subpopulation of men with PCa.

methodsIn the Danish prospective Diet, Cancer, and Health cohort, we identified 2604 men with PCa and 9340 PCa-free men for comparison. We used Cox regression models to investigate the hazard ratios (HR) of T2DM from the date of diagnosis.

resultsDuring 100,408 person-years at risk, 887 men were diagnosed with T2DM. Overall, no increased hazard of T2DM was observed in men with PCa compared to PCa-free men, but within the first year after PCa diagnosis, the HR of T2DM was 70% increased. In all men, the HRs for T2DM increased markedly with overweight/obesity, while comorbidity was associated with a pronounced increased HR in men with PCa. Within the PCa subpopulation, no association between ADT and T2DM was observed.

conclusionMen with PCa have no overall increased risk of being diagnosed with T2DM compared to PCa-free men, despite an increased risk within the first year following cancer diagnosis, likely affected by increased surveillance. IMPLICATIONS FOR CANCER SURVIVORS: Overall, survivors of PCa should not be more concerned about T2DM than PCa-free men; first-line treatment does not change the overall risk of T2DM in survivors of PCa. However, cardiometabolic risk factors require awareness to mitigate the risk of T2DM.