Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study

ABSTRACT Background Glucocorticoids may promote prostate cancer by reducing apoptosis and the immune response, or prevent it by reducing inflammation, inhibiting androgens, and limiting cell proliferation. However, epidemiological evidence is limited. Thus, this study aimed to assess the association...

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Main Authors: Elea Olivier, Blánaid Hicks, Morten Olesen, Agnès Fournier, Gianluca Severi, Anton Pottegård, Manon Cairat
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.71110
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author Elea Olivier
Blánaid Hicks
Morten Olesen
Agnès Fournier
Gianluca Severi
Anton Pottegård
Manon Cairat
author_facet Elea Olivier
Blánaid Hicks
Morten Olesen
Agnès Fournier
Gianluca Severi
Anton Pottegård
Manon Cairat
author_sort Elea Olivier
collection DOAJ
description ABSTRACT Background Glucocorticoids may promote prostate cancer by reducing apoptosis and the immune response, or prevent it by reducing inflammation, inhibiting androgens, and limiting cell proliferation. However, epidemiological evidence is limited. Thus, this study aimed to assess the association between systemic glucocorticoids and prostate cancer risk within the Danish registries. Methods A nationwide case–control study was conducted using Danish healthcare registries. Men with a primary prostate adenocarcinoma diagnosis between 2001 and 2018 were identified as cases (n = 56,575). For each case, 10 controls were randomly selected from the general population, matched on age and calendar time. Exposure to systemic glucocorticoid was identified via the national prescription registry from 1995 onwards. Ever users of systemic glucocorticoids were defined as at least 2 filled prescriptions, and long‐term use as filled prescriptions equivalent to ≥ 1000 defined daily doses (DDDs). Conditional logistic regressions were performed to calculate odds ratios (ORs) and 95% confidence intervals for the association between systemic glucocorticoid use and prostate cancer risk. Results Twelve percent of men had ever been exposed to systemic glucocorticoids. No association was observed between ever and long‐term use of systemic glucocorticoids and prostate cancer risk [OR = 1.03 (1.00–1.06) and OR = 1.02 (0.92–1.14), respectively], compared with never use. However, an inverse association was observed with the highest use category (> 1500 DDDs) [OR = 0.86 (0.74–0.99)], though without evidence of a dose–response relationship [OR per 500 DDDs = 0.98 (0.95–1.01), p = 0.18]. Associations did not differ by prostate cancer stage. Conclusion This large nationwide nested case–control study suggested no evidence of a higher risk of prostate adenocarcinoma associated with systemic glucocorticoid use.
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spelling doaj-art-c6df3be7029f45dfa6b2a4ad0997db772025-08-20T03:46:34ZengWileyCancer Medicine2045-76342025-08-011415n/an/a10.1002/cam4.71110Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control StudyElea Olivier0Blánaid Hicks1Morten Olesen2Agnès Fournier3Gianluca Severi4Anton Pottegård5Manon Cairat6Université Paris‐Saclay UVSQ, Inserm, Gustave Roussy, CESP Villejuif FranceClinical Pharmacology and Pharmacy, Department of Public Health University of Southern Denmark Odense DenmarkClinical Pharmacology and Pharmacy, Department of Public Health University of Southern Denmark Odense DenmarkUniversité Paris‐Saclay UVSQ, Inserm, Gustave Roussy, CESP Villejuif FranceUniversité Paris‐Saclay UVSQ, Inserm, Gustave Roussy, CESP Villejuif FranceClinical Pharmacology and Pharmacy, Department of Public Health University of Southern Denmark Odense DenmarkUniversité Paris‐Saclay UVSQ, Inserm, Gustave Roussy, CESP Villejuif FranceABSTRACT Background Glucocorticoids may promote prostate cancer by reducing apoptosis and the immune response, or prevent it by reducing inflammation, inhibiting androgens, and limiting cell proliferation. However, epidemiological evidence is limited. Thus, this study aimed to assess the association between systemic glucocorticoids and prostate cancer risk within the Danish registries. Methods A nationwide case–control study was conducted using Danish healthcare registries. Men with a primary prostate adenocarcinoma diagnosis between 2001 and 2018 were identified as cases (n = 56,575). For each case, 10 controls were randomly selected from the general population, matched on age and calendar time. Exposure to systemic glucocorticoid was identified via the national prescription registry from 1995 onwards. Ever users of systemic glucocorticoids were defined as at least 2 filled prescriptions, and long‐term use as filled prescriptions equivalent to ≥ 1000 defined daily doses (DDDs). Conditional logistic regressions were performed to calculate odds ratios (ORs) and 95% confidence intervals for the association between systemic glucocorticoid use and prostate cancer risk. Results Twelve percent of men had ever been exposed to systemic glucocorticoids. No association was observed between ever and long‐term use of systemic glucocorticoids and prostate cancer risk [OR = 1.03 (1.00–1.06) and OR = 1.02 (0.92–1.14), respectively], compared with never use. However, an inverse association was observed with the highest use category (> 1500 DDDs) [OR = 0.86 (0.74–0.99)], though without evidence of a dose–response relationship [OR per 500 DDDs = 0.98 (0.95–1.01), p = 0.18]. Associations did not differ by prostate cancer stage. Conclusion This large nationwide nested case–control study suggested no evidence of a higher risk of prostate adenocarcinoma associated with systemic glucocorticoid use.https://doi.org/10.1002/cam4.71110Danish registriesglucocorticoidspharmacoepidemiologyprostate cancer
spellingShingle Elea Olivier
Blánaid Hicks
Morten Olesen
Agnès Fournier
Gianluca Severi
Anton Pottegård
Manon Cairat
Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
Cancer Medicine
Danish registries
glucocorticoids
pharmacoepidemiology
prostate cancer
title Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
title_full Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
title_fullStr Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
title_full_unstemmed Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
title_short Use of Systemic Glucocorticoids and Risk of Prostate Adenocarcinoma: Evidence From a Danish Population‐Based Case–Control Study
title_sort use of systemic glucocorticoids and risk of prostate adenocarcinoma evidence from a danish population based case control study
topic Danish registries
glucocorticoids
pharmacoepidemiology
prostate cancer
url https://doi.org/10.1002/cam4.71110
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