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

PURPOSE: To 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.

METHODS: In 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.

RESULTS: During 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.

CONCLUSION: Men 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.