Risk factors for incident prostate cancer in a cohort of world trade center responders
| Autor: | Pei Fen Kuan, Sean A. P. Clouston, Benjamin J. Luft, Evelyn J. Bromet, Soumyadeep Mukherjee, Roman Kotov, Patricia Thompson-Carino |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty lcsh:RC435-571 Comorbidity Cohort Studies Disasters Stress Disorders Post-Traumatic 03 medical and health sciences Prostate cancer 0302 clinical medicine Cancer epidemiology Prostate Risk Factors Internal medicine lcsh:Psychiatry Epidemiology of cancer medicine Humans Proportional hazards model business.industry Incidence (epidemiology) Prostate Cancer Incidence Confounding Emergency Responders Posttraumatic stress disorder Prostatic Neoplasms Middle Aged medicine.disease 3. Good health Psychiatry and Mental health medicine.anatomical_structure Prostate cancer screening 030220 oncology & carcinogenesis Cohort September 11 Terrorist Attacks business World trade center 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Psychiatry BMC Psychiatry, Vol 19, Iss 1, Pp 1-8 (2019) |
| ISSN: | 1471-244X |
| Popis: | Background Despite a relatively young average age and no routine screening, prostate cancer is one of the most common cancers in men who worked at the World Trade Center (WTC) following the 9/11/2001 disaster. This study evaluated whether re-experiencing stressful memories of a traumatic event was associated with prostate cancer incidence. Methods Participants were males from one clinical center that monitors the health of first-responders (N = 6857). Monitoring began in July 2002 and occurs annually but does not include prostate cancer screening. Severity of physical exposures and of re-experiencing memories and stress responses were measured at study enrollment using standardized and validated methods in all participants. The outcome was incidence of diagnosed prostate cancer after enrollment (n = 68). Bivariate analyses provided age-adjusted incidence rates (aIR). Cox proportional hazards modeling was used to calculate incidence; hazards ratios (HR) were reported. Results The mean age of responders on 9/11/2001 was 37.9 years. Prostate cancer incidence was lowest in responders with no re-experiencing stress (aIR = 250.83/100,000 person-years, [233.41–268.25]) and highest in responders with severe re-experiencing stress (aIR = 818.49/100,000 person-years, [801.07–835.91]). Cox proportional hazards regression revealed that re-experiencing the stressful events of 9/11/2001 was associated with increased prostate cancer incidence (HR = 1.96 [1.26–3.05], P = 0.003), even upon adjusting for confounders. Conclusions This is the first study to identify a positive association between re-experiencing a traumatic event and prostate cancer incidence. Our results are consistent with recent rodent model evidence demonstrating a direct biological link between stress pathways and prostate tumorigenesis and offer new hypotheses in the causality of prostate cancer. |
| Databáze: | OpenAIRE |
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