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Version of Record online: 26 JUL 2007
Copyright © 2007 American Cancer Society
Volume 110, Issue 7, pages 1493–1500, 1 October 2007
How to Cite
Saigal, C. S., Gore, J. L., Krupski, T. L., Hanley, J., Schonlau, M. and Litwin, M. S. (2007), Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer, 110: 1493–1500. doi: 10.1002/cncr.22933
The NIDDK reviewed and approved this article.
This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors.
- Issue online: 14 SEP 2007
- Version of Record online: 26 JUL 2007
- Manuscript Accepted: 6 APR 2007
- Manuscript Revised: 4 APR 2007
- Manuscript Received: 18 JAN 2007
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- prostate cancer;
- androgen deprivation therapy;
- cardiovascular disease;
- overall survival
The use of androgen deprivation therapy (ADT) in the treatment of men with prostate cancer has risen sharply. Although cardiovascular disease is the most common reason for death among men with prostate cancer who do not die of the disease itself, data regarding the effect of ADT on cardiovascular morbidity and mortality in men with prostate cancer are limited. In the current study, the authors attempted to measure the risk for subsequent cardiovascular morbidity in men with prostate cancer who received ADT.
A cohort of newly diagnosed men in a population-based registry who were diagnosed between 1992 and 1996 were identified retrospectively. A total of 22,816 subjects were identified after exclusion criteria were applied. Using a multivariate model, the authors calculated the risk of subsequent cardiovascular morbidity in men with prostate cancer who were treated with ADT, as defined using Medicare claims.
Newly diagnosed prostate cancer patients who received ADT for at least 1 year were found to have a 20% higher risk of serious cardiovascular morbidity compared with similar men who did not receive ADT. Subjects began incurring this higher risk within 12 months of treatment. However, Hispanic men were found to have a lowered risk for cardiovascular morbidity.
ADT is associated with significantly increased cardiovascular morbidity in men with prostate cancer and may lower overall survival in men with low-risk disease. These data have particular relevance to decisions regarding the use of ADT in men with prostate cancer in settings in which the benefit has not been clearly established. For men with metastatic disease, focused efforts to reduce cardiac risk factors through diet, exercise, or the use of lipid-lowering agents may mitigate some of the risks of ADT. Cancer 2007. © 2007 American Cancer Society.