Abstract
Pre-clinical evidence suggests that 5-alpha reductase inhibitors, prescribed in the treatment of benign prostatic hyperplasia, reduce colorectal and gastro-oesophageal cancer incidence via action on the male hormonal pathway. However, few studies to date have investigated this association at the population level. This study aimed to investigate the risk of colorectal and gastro-oesophageal cancers with the use of 5-alpha reductase inhibitors. We conducted
a retrospective cohort study of new users of 5-alpha reductase inhibitors and alpha blockers among patients with benign prostatic hyperplasia in the United Kingdom Clinical Practice Research Datalink. Patients were followed until a first ever diagnosis of colorectal or gastro oesophageal cancer, death from any cause or end of registration with the general practice or 31st of December 2017. Cox proportional hazards models with inverse probability of treatment weights were used to calculate weighted hazard ratios (HR) and 95% confidence intervals (CIs) of incident colorectal cancer or gastro-oesophageal cancer associated with
the use of 5-alpha reductase inhibitors compared with alpha-blockers. During a mean follow-up of 6.6 years, we found no association between the use of 5-alpha reductase inhibitors and colorectal (HR:1.13, 95% CI 0.91-1.41) or gastro-oesophageal (HR 1.14, 95% CI 0.76-1.63) cancer risk compared to alpha-blockers. Sensitivity analysis showed largely consistent results when varying lag periods, using multiple imputation, and accounting for competing risk of death. This study found no association between the use of 5-alpha reductase inhibitors and risk of colorectal or gastro-oesophageal cancer in men with benign prostatic hyperplasia.
a retrospective cohort study of new users of 5-alpha reductase inhibitors and alpha blockers among patients with benign prostatic hyperplasia in the United Kingdom Clinical Practice Research Datalink. Patients were followed until a first ever diagnosis of colorectal or gastro oesophageal cancer, death from any cause or end of registration with the general practice or 31st of December 2017. Cox proportional hazards models with inverse probability of treatment weights were used to calculate weighted hazard ratios (HR) and 95% confidence intervals (CIs) of incident colorectal cancer or gastro-oesophageal cancer associated with
the use of 5-alpha reductase inhibitors compared with alpha-blockers. During a mean follow-up of 6.6 years, we found no association between the use of 5-alpha reductase inhibitors and colorectal (HR:1.13, 95% CI 0.91-1.41) or gastro-oesophageal (HR 1.14, 95% CI 0.76-1.63) cancer risk compared to alpha-blockers. Sensitivity analysis showed largely consistent results when varying lag periods, using multiple imputation, and accounting for competing risk of death. This study found no association between the use of 5-alpha reductase inhibitors and risk of colorectal or gastro-oesophageal cancer in men with benign prostatic hyperplasia.
| Original language | English |
|---|---|
| Journal | International Journal of Cancer |
| Publication status | Accepted/In press - 7 Mar 2024 |
Bibliographical note
Funding2his work was funded by a Cancer Research UK Population Research Fellowship (grant reference 22185). The funder had no role in the study design, analysis, interpretation or writing of the manuscript.
Data Availability Statement
Data AvailabilityData is available from the authors upon reasonable request with the permission of CPRD.
Keywords
- benign prostatic hyperplasia
- colorectal cancer
- gastro-oesophageal cancer
- 5- alpha reductase inhibitor
- cancer epidemiology
