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A stage-dependent link between metabolic syndrome components and incident prostate cancer

Review article
Authors Jan Hammarsten
Jan-Erik Damber
Mohammad-Ali Haghsheno
Dan Mellström
Ralph Peeker
Published in Nature Reviews Urology
Volume 15
Issue 5
Pages 321-333
ISSN 1759-4812
Publication year 2018
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Clinical Sciences, Department of Urology
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 321-333
Language en
Keywords antidiabetic agent, insulin, sex hormone, cancer incidence, cancer research, cancer staging, diabetes mellitus, disease association, human, insulin blood level, lethality, medical care, metabolic syndrome X, priority journal, prostate cancer, Review
Subject categories Cancer and Oncology, Urology and andrology


Metabolic syndrome is associated with increased cancer risk and progression at almost all sites, including the prostate in high-stage prostate cancer. However, several reports have described an inverse relationship between metabolic syndrome and its components and low-stage incident prostate cancer. Such anomalies in cancer research hamper efforts to fight cancer. Evidence suggests that metabolic syndrome and its components have two distinct effects in prostate cancer, concealing prostate cancer in low-stage disease and promoting progression to high-stage incident, nonlocalized, and lethal prostate cancer. The concealment of prostate cancer by metabolic syndrome and its components might be related to bias mechanisms that reduce PSA level and lead to a delayed diagnosis of low-stage prostate cancer, meaning that fewer men with metabolic syndrome are diagnosed with low-stage disease. The inverse link between metabolic syndrome and its components and low-stage incident prostate cancer might simply be the result of such bias and the shortcomings of the diagnostic procedure rather than being related to prostate cancer biology itself. The evidence summarized here supports the hypothesis that the link between metabolic syndrome and its components and incident prostate cancer is a two-way and stage-dependent one, a theory that requires further research. © 2018 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.

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