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5-Alpha reductase inhibitor use and prostate cancer survival in the Finnish Prostate Cancer Screening Trial.

https://arctichealth.org/en/permalink/ahliterature275383
Source
Int J Cancer. 2016 Jun 15;138(12):2820-8
Publication Type
Article
Date
Jun-15-2016
Author
Teemu J Murtola
Elina K Karppa
Kimmo Taari
Kirsi Talala
Teuvo L J Tammela
Anssi Auvinen
Source
Int J Cancer. 2016 Jun 15;138(12):2820-8
Date
Jun-15-2016
Language
English
Publication Type
Article
Keywords
5-alpha Reductase Inhibitors - therapeutic use
Aged
Antineoplastic Agents - therapeutic use
Early Detection of Cancer
Finland - epidemiology
Humans
Kaplan-Meier Estimate
Male
Mass Screening
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prostatic Neoplasms - diagnosis - drug therapy - mortality
Abstract
Randomized clinical trials have shown that use of 5a-reductase inhibitors (5-ARIs) lowers overall prostate cancer (PCa) risk compared to placebo, while the proportion of Gleason 8-10 tumors is elevated. It is unknown whether this affects PCa-specific survival. We studied disease-specific survival by 5-ARI usage in a cohort of 6,537 prostate cancer cases diagnosed in the Finnish Prostate Cancer Screening Trial and linked to the national prescription database for information on medication use. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals for prostate cancer-specific deaths. For comparison, survival among alpha-blocker users was also evaluated. During the median follow-up of 7.5 years after diagnosis a total of 2,478 men died; 617 due to prostate cancer and 1,861 due to other causes. The risk of prostate cancer death did not differ between 5-ARI users and nonusers (multivariable adjusted HR 0.94, 95% CI 0.72-1.24 and HR 0.98, 95% CI 0.69-1.41 for usage before and after the diagnosis, respectively). Alpha-blocker usage both before and after diagnosis was associated with increased risk of prostate cancer death (HR 1.29, 95% CI 1.08-1.54 and HR 1.56, 95% CI 1.30-1.86, respectively). The risk increase vanished in long-term alpha-blocker usage. Use of 5-ARIs does not appear to affect prostate cancer mortality when used in management of benign prostatic hyperplasia. Increased risk associated with alpha-blocker usage should prompt further exploration on the prognostic role of lower urinary tract symptoms.
PubMed ID
26804670 View in PubMed
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Allopurinol and risk of benign prostatic hyperplasia in a Finnish population-based cohort.

https://arctichealth.org/en/permalink/ahliterature296680
Source
Prostate Cancer Prostatic Dis. 2018 09; 21(3):373-378
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2018
Author
Ville Kukko
Antti Kaipia
Kirsi Talala
Kimmo Taari
Teuvo L J Tammela
Anssi Auvinen
Teemu J Murtola
Author Affiliation
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. kukko.ville.t@student.uta.fi.
Source
Prostate Cancer Prostatic Dis. 2018 09; 21(3):373-378
Date
09-2018
Language
English
Publication Type
Evaluation Studies
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Allopurinol - therapeutic use
Cohort Studies
Finland - epidemiology
Free Radical Scavengers - therapeutic use
Gout - drug therapy
Gout Suppressants - therapeutic use
Humans
Male
Middle Aged
Prostatic Hyperplasia - epidemiology - prevention & control
Risk assessment
Risk factors
Abstract
Metabolic syndrome and obesity are linked with hyperuricemia, and it has also been proposed that oxidative stress associated with hyperuricemia may promote benign prostatic hyperplasia (BPH). However, it is currently unknown whether use of antihyperuricemic medication is associated with risk of developing BPH. We studied the association between BPH and use of antihyperuricemic allopurinol in a Finnish population-based cohort.
The study cohort consisted of 74,754 men originally identified for the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC). Information on gout and BPH medication usage (5a-reductase inhibitors, 5ARIs) during 1996-2014 was obtained from the National medication reimbursement database. Information on BPH diagnoses from in- and outpatient hospital visits and BPH-related surgery was obtained from the National Health Care Registry. Men with a record of BPH at baseline was excluded. We used Cox regression to analyze risk of starting BPH medication, having a recorded diagnosis or undergoing BPH surgery by allopurinol use with adjustment for age and simultaneous use of statins, antidiabetic or antihypertensive drugs and aspirin or other NSAIDs. Medication use was analyzed as a time-dependent variable to minimize immortal time bias.
Men using allopurinol had a decreased risk for all three BPH endpoints: BPH medication (HR 0.81; 95% CI 0.75-0.88), BPH diagnosis (HR 0.78; 95% CI 0.71-0.86) and BPH-related surgery (HR 0.67; 95% CI 0.58-0.76) after multivariable adjustment. The risk association did not change by cumulative use. The risk decrease disappeared after 1-2 years lag time. Only BMI modified the risk association; the risk decrease was observed only among men with BMI above the median (27.3?kg/m2); p for interaction
PubMed ID
29273728 View in PubMed
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An association of serum vitamin D concentrations < 40 nmol/L with acute respiratory tract infection in young Finnish men.

https://arctichealth.org/en/permalink/ahliterature161510
Source
Am J Clin Nutr. 2007 Sep;86(3):714-7
Publication Type
Article
Date
Sep-2007
Author
Ilkka Laaksi
Juha-Petri Ruohola
Pentti Tuohimaa
Anssi Auvinen
Riina Haataja
Harri Pihlajamäki
Timo Ylikomi
Author Affiliation
Department of Cell Biology and Anatomy, Medical School, University of Tampere, Tampere, Finland. ilkka.laaksi@uta.fi
Source
Am J Clin Nutr. 2007 Sep;86(3):714-7
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adult
Analysis of Variance
Disease Susceptibility
Exercise - physiology
Finland - epidemiology
Humans
Incidence
Male
Military Personnel
Odds Ratio
Respiratory Tract Infections - blood - epidemiology - prevention & control
Smoking - blood
Vitamin D - analogs & derivatives - blood - therapeutic use
Vitamin D Deficiency - blood - epidemiology - prevention & control
Abstract
The effects of vitamin D in regulating bone mineralization are well documented. The action of vitamin D as a key link between Toll-like receptor activation and antibacterial responses in innate immunity has recently been shown. The data suggest that differences in the ability of human populations to produce vitamin D may contribute to susceptibility to microbial infection.
We aimed to explore whether an association exists between vitamin D insufficiency and acute respiratory tract infection in young Finnish men.
Young Finnish men (n = 800) serving on a military base in Finland were enrolled for this study. Their serum 25-hydroxyvitamin [25(OH)D] concentrations were measured in July 2002. They were followed for 6 mo, and the number of days of absence from duty due to respiratory infection were counted.
The mean (+/- SD) serum 25(OH)D concentrations were 80.2 +/- 29.3 nmol/L (n = 756). Subjects with serum 25(OH)D concentrations
PubMed ID
17823437 View in PubMed
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Androgen receptor gene alterations in Finnish male breast cancer.

https://arctichealth.org/en/permalink/ahliterature186530
Source
Breast Cancer Res Treat. 2003 Jan;77(2):167-70
Publication Type
Article
Date
Jan-2003
Author
Kirsi Syrjäkoski
Eija-R Hyytinen
Tuula Kuukasjärvi
Anssi Auvinen
Olli-P Kallioniemi
Tommi Kainu
Pasi A Koivisto
Author Affiliation
Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere, Tampere University Hospital, Tampere, Finland.
Source
Breast Cancer Res Treat. 2003 Jan;77(2):167-70
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms, Male - diagnosis - genetics
Cohort Studies
Finland
Genetic Predisposition to Disease
Genetic Testing
Germ-Line Mutation - genetics
Humans
Male
Middle Aged
Mutation - genetics
Prostatic Neoplasms - genetics
Receptors, Androgen - genetics
Risk factors
Abstract
Mutations in the androgen receptor (AR) gene have been suggested to predispose to male breast cancer (MBC). Studies on MBC patients have not been based on the mutation screening of the entire coding region of the AR and the number of subjects has been small. Therefore, some AR gene alterations may have remained undetected. In the present study, we have comprehensively screened the entire coding region of the AR gene for mutations and also studied the role of AR CAG and GGC repeat lengths as risk factors for MBC in a cohort of 32 Finnish MBC patients. To estimate the possible involvement of the prostate cancer predisposing AR Arg726Leu germ-line mutation in MBC, this mutation was tested in 117 MBC patients. No germ-line mutations were found and the CAG and GGC repeat lengths were similar among MBC cases as among Scandinavian population. Our data indicate that the AR gene does not substantially contribute to MBC predisposition.
PubMed ID
12602915 View in PubMed
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Antidiabetic drug use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer.

https://arctichealth.org/en/permalink/ahliterature284128
Source
Scand J Urol. 2017 Feb;51(1):5-12
Publication Type
Article
Date
Feb-2017
Author
Antti Haring
Teemu J Murtola
Kirsi Talala
Kimmo Taari
Teuvo L J Tammela
Anssi Auvinen
Source
Scand J Urol. 2017 Feb;51(1):5-12
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Aged
Diabetes Mellitus - drug therapy
Dose-Response Relationship, Drug
Early Detection of Cancer
Finland - epidemiology
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Metformin - therapeutic use
Middle Aged
Multivariate Analysis
Neoplasm Metastasis
Proportional Hazards Models
Prostatic Neoplasms - diagnosis - epidemiology - pathology
Protective factors
Randomized Controlled Trials as Topic
Risk factors
Sulfonylurea Compounds - therapeutic use
Thiazolidinediones - therapeutic use
Abstract
Diabetic men have lowered overall prostate cancer (PCa) risk, while their risk of high-grade disease may be elevated. The antidiabetic drug metformin may reduce the risk. This study evaluated PCa incidence among users of metformin and other antidiabetic drugs in the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC).
The study population (78,615 men) was linked to the national prescription database. Hazard ratios (HRs) and 95% confidence intervals (CIs) for PCa were estimated using Cox regression, with medication use as a time-dependent variable. The effect of diabetes was estimated by comparing antidiabetic drug users to non-users, while drug-specific effects were evaluated within antidiabetic drug users. Analyses were performed in both study arms of FinRSPC.
Compared to non-users, men using antidiabetic drugs had lowered overall PCa risk (HR 0.85, 95% CI 0.79-0.92), and this association was not affected by PCa screening. However, the risk of metastatic PCa was increased (HR 1.44, 95% CI 1.09-1.91). Among antidiabetic drug users, metformin decreased overall PCa risk (HR 0.81, 95% CI 0.69-0.95) in a dose-dependent manner. When stratified by FinRSPC study arm, the risk reduction was observed only in the screening arm. Sulphonylureas increased the risk of metastatic PCa (HR 2.04, 95% CI 1.11-3.77). Use of thiazoledenediones or insulin was not associated with PCa risk.
Among antidiabetic drug users, metformin lowered the overall PCa risk, while the risk of metastatic disease was elevated in sulphonylurea users. As sulphonylureas stimulate insulin secretion, the results suggest that hyperinsulinemia may be a risk factor for PCa.
PubMed ID
28084175 View in PubMed
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Antidiabetic medication and prostate cancer risk: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature155693
Source
Am J Epidemiol. 2008 Oct 15;168(8):925-31
Publication Type
Article
Date
Oct-15-2008
Author
Teemu J Murtola
Teuvo L J Tammela
Jorma Lahtela
Anssi Auvinen
Author Affiliation
School of Public Health, University of Tampere, Medisiinarinkatu 3, 33520 Tampere, Finland. teemu.murtola@uta.fi
Source
Am J Epidemiol. 2008 Oct 15;168(8):925-31
Date
Oct-15-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Case-Control Studies
Finland
Humans
Hypoglycemic Agents - adverse effects
Incidence
Male
Middle Aged
Prostate-Specific Antigen
Prostatic Neoplasms - chemically induced - epidemiology
Risk factors
Abstract
Decreased risk of prostate cancer in diabetic men has been reported. The authors evaluated the association between antidiabetic medication use and prostate cancer at the population level. All incident prostate cancer cases in Finland during 1995-2002 were identified from the Finnish Cancer Registry. Matched controls were provided by the Population Register Center (24,723 case-control pairs). Information on medication use was obtained from a comprehensive prescription database. Multivariable-adjusted odds ratios were computed by using conditional logistic regression. The authors found that prostate cancer risk was decreased for antidiabetic medication users (odds ratio = 0.87, 95% confidence interval: 0.82, 0.92). The decrease was observed for most drug groups. The odds ratio decreased in a dose-dependent fashion by quantity of use. Duration of antidiabetic treatment was inversely associated with overall prostate cancer risk and risk of advanced cancer. Similar risk reduction for users of different antidiabetic drugs suggests that diabetes, instead of the medication itself, is behind the association. This finding is unlikely to be secondary because of differential uptake of the prostate-specific antigen test or different prostate-specific antigen levels between medication users and nonusers; prevalence of testing in Finland is low. Dose and time dependency of the relation probably indicates that duration of diabetes is negatively associated with risk.
PubMed ID
18700234 View in PubMed
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Antiepileptic drugs with histone deacetylase inhibition activity and prostate cancer risk: a population-based case-control study.

https://arctichealth.org/en/permalink/ahliterature278241
Source
Cancer Causes Control. 2016 May;27(5):637-45
Publication Type
Article
Date
May-2016
Author
Jukka K Salminen
Teuvo L J Tammela
Anssi Auvinen
Teemu J Murtola
Source
Cancer Causes Control. 2016 May;27(5):637-45
Date
May-2016
Language
English
Publication Type
Article
Keywords
Aged
Anticonvulsants - therapeutic use
Case-Control Studies
Databases, Factual
Finland - epidemiology
Histone Deacetylase Inhibitors - therapeutic use
Histone Deacetylases
Humans
Male
Middle Aged
Odds Ratio
Prostatic Neoplasms - prevention & control
Registries
Research Design
Risk factors
Abstract
Previous studies suggest that antiepileptic drugs with histone deacetylase (HDAC) inhibitor properties may have prostate cancer preventive effects. We evaluated the association between antiepileptic drug use and prostate cancer risk in a population-based case-control study. The study included all new prostate cancer cases diagnosed in Finland in 1995-2002 and matched controls (24,657 case-control pairs) identified from the Finnish Cancer Registry and the Population Register Center, respectively. Information on antiepileptic drug purchases was obtained from the national prescription reimbursement database. Odds ratios and their 95 % confidence intervals were estimated using age-adjusted and multivariable-adjusted conditional logistic regression analysis. Compared to never-users of antiepileptic drugs, the overall prostate cancer risk was decreased among users of phenobarbital, carbamazepine, and valproic acid (multivariable-adjusted odds ratio (OR) 0.47, 95 % CI 0.24-0.92; OR 0.82, 95 % CI 0.71-0.94, and OR 0.62, 95 % CI 0.42-0.92, respectively), but not among users of other antiepileptic drugs. Overall prostate cancer risk decreased in a dose-dependent manner by cumulative amount, duration and yearly dosage (intensity) of HDAC inhibitors valproic acid and carbamazepine. The risk of advanced prostate cancer was decreased only among carbamazepine users (OR 0.65, 95 % CI 0.44-0.96). Our results support possible prostate cancer preventive effects of HDAC inhibitors. However, also phenobarbital use was associated with decreased prostate cancer risk, despite not having HDAC inhibiting activity. The mechanism of action for antiepileptic drugs in prostate cancer deserves further study.
PubMed ID
27038166 View in PubMed
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Antihypertensive drugs and prostate cancer risk in a Finnish population-based cohort.

https://arctichealth.org/en/permalink/ahliterature302616
Source
Scand J Urol. 2018 Oct - Dec; 52(5-6):321-327
Publication Type
Journal Article
Author
Aino Siltari
Teemu J Murtola
Kirsi Talala
Kimmo Taari
Teuvo L J Tammela
Anssi Auvinen
Author Affiliation
a Faculty of Medicine, Pharmacology , University of Helsinki , Helsinki , Finland.
Source
Scand J Urol. 2018 Oct - Dec; 52(5-6):321-327
Language
English
Publication Type
Journal Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antihypertensive Agents - therapeutic use
Cohort Studies
Diuretics - therapeutic use
Finland - epidemiology
Humans
Hypertension - drug therapy - epidemiology
Male
Middle Aged
Proportional Hazards Models
Prostatic Neoplasms - epidemiology
Risk factors
Abstract
The etiology of prostate cancer (PCa) involves environmental and genetic factors. Understanding the role of medication use on PCa risk may clarify the pathophysiological changes and mechanisms in development of cancer.
This study investigated PCa risk in relation to overall use of anti-hypertensive drugs and those with specific mechanisms of action. The study cohort (78,615 men) was linked to the prescription database to obtain information on medication use during 20-year follow-up. Information was obtained on PCa diagnoses, causes of deaths, and for a sub-set on B.M.I. and use of non-prescription drugs. Time-dependent drug use variables hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression analyses.
Use of antihypertensive drugs slightly increased PCa risk (HR = 1.16, 95% CI = 1.11-1.22). The risk increase was clearest for metastatic PCa (HR = 1.36, 95% CI = 1.14-1.62). ACE inhibitors, beta-blockers, and diuretics were all separately associated with a small excess risk (HR = 1.10, 95% CI = 1.01-1.19, HR = 1.14, 95% CI = 1.06-1.21, and HR = 1.16, 95% CI = 1.07-1.27, respectively). None of the other groups showed a clear association with PCa risk.
The use of antihypertensive drugs was associated with increased prostate cancer risk. Similar risk association for multiple drug groups suggests that the findings may not reflect a direct medication effect, but may be due to underlying hypertension.
PubMed ID
30698056 View in PubMed
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Asbestos exposure as a risk factor for retroperitoneal fibrosis.

https://arctichealth.org/en/permalink/ahliterature180279
Source
Lancet. 2004 May 1;363(9419):1422-6
Publication Type
Article
Date
May-1-2004
Author
Toomas Uibu
Panu Oksa
Anssi Auvinen
Eero Honkanen
Kaj Metsärinne
Heikki Saha
Jukka Uitti
Pekka Roto
Author Affiliation
Department of Respiratory Medicine, Tampere University Hospital, Finland. toomas.uibu@saunalahti.fi
Source
Lancet. 2004 May 1;363(9419):1422-6
Date
May-1-2004
Language
English
Publication Type
Article
Keywords
Aged
Asbestos - adverse effects
Case-Control Studies
Finland - epidemiology
Humans
Male
Middle Aged
Occupational Diseases - epidemiology - etiology
Occupational Exposure
Odds Ratio
Prevalence
Questionnaires
Retroperitoneal Fibrosis - epidemiology - etiology
Risk factors
Abstract
Retroperitoneal fibrosis (RPF) is an uncommon disease with unknown causation in most cases. The pathognomonic finding is a fibrous mass covering the abdominal aorta and the ureters. Our aim was to clarify the possible role of asbestos exposure in the development of RPF. The hypothesis was based on the ability of asbestos to cause fibrosis in pulmonary and pleural tissue.
We undertook a case-control study of 43 patients with the disease (86% of eligible cases) treated in three university hospital districts of Finland in 1990-2001. For every patient, five population-based controls were selected, matched by age, sex, and central hospital district. We assessed asbestos exposure and medical history using a postal questionnaire and a personal interview. Of the 215 eligible controls, 179 (83%) participated in the study.
The age-standardised incidence of RPF was 0.10 (95% CI 0.07-0.14) per 100?000 person-years. The disease was strongly associated with asbestos exposure. The odds ratio (OR) was 5.54 (1.64-18.65) for less than 10 fibre-years of asbestos exposure and 8.84 (2.03-38.50) for 10 or more fibre-years, the attributable fraction being 82% and 89%, respectively. Other risk factors were previous use of ergot derivates (OR 9.92 [1.63-60.26]), abdominal aortic aneurysm (OR 6.73 [0.81-56.08]), and smoking for more than 20 pack-years (OR 4.73 [1.28-17.41]).
Our results show that occupational asbestos exposure is an important causal factor for RPF. For patients with work-related asbestos exposure, RPF should be considered an occupational disease.
PubMed ID
15121404 View in PubMed
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Assessment of causes of death in a prostate cancer screening trial.

https://arctichealth.org/en/permalink/ahliterature160839
Source
Int J Cancer. 2008 Jan 15;122(2):413-7
Publication Type
Article
Date
Jan-15-2008
Author
Tuukka Mäkinen
Pekka Karhunen
Jussi Aro
Jorma Lahtela
Liisa Määttänen
Anssi Auvinen
Author Affiliation
Department of Surgery, Tampere University Hospital, Tampere, Finland. tuukka.makinen@netikka.fi
Source
Int J Cancer. 2008 Jan 15;122(2):413-7
Date
Jan-15-2008
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death
Death Certificates
Finland
Humans
Male
Mass Screening
Middle Aged
Prostatic Neoplasms - diagnosis - mortality
Randomized Controlled Trials as Topic
Registries
Sensitivity and specificity
Abstract
Accurate assessment of the causes of death is crucial for a conclusive evaluation of the ongoing prostate cancer screening trials. Here, we report the validity of the official causes of death as compared with an independent expert review in the Finnish prostate cancer screening trial. Because nearly 80,000 men were involved, death-cause evaluation was restricted to men diagnosed for prostate cancer. Medical charts were retrieved and the cause of death was assigned by an expert review panel for all deaths among men with prostate cancer during the study period, 1996-2003. The panel decision was compared with both death certificates and the official causes of death as assigned by Statistics Finland. Of a total of 315 deaths, the review panel attributed 127 (41%) to prostate cancer and 184 (59%) to other causes, the corresponding figures in death certificates being 124 (40%) and 187 (60%). Four cases were excluded because of insufficient information. The death-certificate data were in agreement with the panel's assessment in 305 out of 311 cases (overall agreement 97.7%, kappa = 0.95). The overall agreement between the official causes of death and the panel's decision was 97.4% (304/311, kappa = 0.95). The sensitivity of the certificates in identifying prostate cancer deaths was 96.1% (panel as golden standard). Correspondingly, specificity was 98.9%. The official causes of death thus provide an accurate means for evaluating disease-specific mortality in a large population-based prostate-cancer screening trial in Finland.
PubMed ID
17935123 View in PubMed
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144 records – page 1 of 15.