Fatherhood status and risk of prostate cancer: Nationwide,population‐based case–control study |
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Authors: | Sara M Wirén Linda I Drevin Sigrid V Carlsson Olof Akre Erik C Holmberg David E Robinson Hans G Garmo Pär E Stattin |
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Institution: | 1. Department of Surgery and Perioperative Sciences, Urology and Andrology, Ume? University, , Ume?, Sweden;2. Regional Cancer Centre, Uppsala University Hospital, , Uppsala, Sweden;3. Department of Urology, Sahlgrenska Academy, University of Gothenburg, , Gothenburg, Sweden;4. Department of Surgery, Urology Service, Memorial Sloan‐Kettering Cancer Center, , New York, NY;5. Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, , Stockholm, Sweden;6. Regional Cancer Centre, Sahlgrenska University Hospital, , Gothenburg, Sweden;7. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, , Gothenburg, Sweden;8. Department of Urology, Ryhov County Hospital, , J?nk?ping, Sweden;9. King's College London, School of Medicine, Division of Cancer Studies, Cancer Epidemiology Group, , London, United Kingdom |
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Abstract: | Previous studies have shown a decreased risk of prostate cancer for childless men; however, the cause of the association remains to be elucidated. The aim of our study was to assess the risk of prostate cancer by fatherhood status, also considering potential confounding factors. In a case–control study in Prostate Cancer data Base Sweden 2.0, a nationwide, population‐based cohort, data on number of children, marital status, education, comorbidity and tumor characteristics obtained through nationwide healthcare registers and demographic databases for 117,328 prostate cancer cases and 562,644 controls, matched on birth year and county of residence, were analyzed. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for prostate cancer overall and by risk category, adjusting for marital status and education. Childless men had a decreased risk of prostate cancer compared to fathers, OR = 0.83 (95% CI = 0.82–0.84), and risk was lower for low‐risk prostate cancer, OR = 0.74 (95% CI = 0.72–0.77), than for metastatic prostate cancer, OR = 0.93 (95% CI = 0.90–0.97). Adjustment for marital status and education attenuated the association in the low‐risk category, adjusted OR = 0.87 (95% CI = 0.84–0.91), whereas OR for metastatic cancer remained virtually unchanged, adjusted OR = 0.92 (95% CI = 0.88–0.96). Our data indicate that the association between fatherhood status and prostate cancer to a large part is due to socioeconomic factors influencing healthcare‐seeking behavior including testing of prostate‐specific antigen levels. |
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Keywords: | prostate cancer epidemiology case– control studies hypogonadism androgens |
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