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BMC Psychiatry
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Prostate Cancer | Research article

Risk factors for incident prostate cancer in a cohort of world trade center responders

Authors: Sean A. P. Clouston, Peifen Kuan, Roman Kotov, Soumyadeep Mukherjee, Patricia Thompson-Carino, Evelyn J. Bromet, Benjamin J. Luft

Published in: BMC Psychiatry | Issue 1/2019

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Abstract

Background

Despite a relatively young average age and no routine screening, prostate cancer is one of the most common cancers in men who worked at the World Trade Center (WTC) following the 9/11/2001 disaster. This study evaluated whether re-experiencing stressful memories of a traumatic event was associated with prostate cancer incidence.

Methods

Participants were males from one clinical center that monitors the health of first-responders (N = 6857). Monitoring began in July 2002 and occurs annually but does not include prostate cancer screening. Severity of physical exposures and of re-experiencing memories and stress responses were measured at study enrollment using standardized and validated methods in all participants. The outcome was incidence of diagnosed prostate cancer after enrollment (n = 68). Bivariate analyses provided age-adjusted incidence rates (aIR). Cox proportional hazards modeling was used to calculate incidence; hazards ratios (HR) were reported.

Results

The mean age of responders on 9/11/2001 was 37.9 years. Prostate cancer incidence was lowest in responders with no re-experiencing stress (aIR = 250.83/100,000 person-years, [233.41–268.25]) and highest in responders with severe re-experiencing stress (aIR = 818.49/100,000 person-years, [801.07–835.91]). Cox proportional hazards regression revealed that re-experiencing the stressful events of 9/11/2001 was associated with increased prostate cancer incidence (HR = 1.96 [1.26–3.05], P = 0.003), even upon adjusting for confounders.

Conclusions

This is the first study to identify a positive association between re-experiencing a traumatic event and prostate cancer incidence. Our results are consistent with recent rodent model evidence demonstrating a direct biological link between stress pathways and prostate tumorigenesis and offer new hypotheses in the causality of prostate cancer.
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Metadata
Title
Risk factors for incident prostate cancer in a cohort of world trade center responders
Authors
Sean A. P. Clouston
Peifen Kuan
Roman Kotov
Soumyadeep Mukherjee
Patricia Thompson-Carino
Evelyn J. Bromet
Benjamin J. Luft
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2383-1

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