Dataset Information

Insufficient Sleep and Risk of Prostate Cancer in a Large Swedish Cohort.

ABSTRACT:

Study objective

There are some data to suggest that insufficient sleep, including short sleep duration and sleep disruption, may be associated with an increased risk of cancer. We investigated the association between sleep duration and sleep disruption and risk of prostate cancer.

Design

Prospective cohort study.

Setting

Sweden.

Participants

A total of 14,041 men in the Swedish National March Cohort.

Interventions

None.

Measurements and results

Habitual sleep duration and sleep disruption were self-reported in 1997. Prostate cancer diagnoses, including lethal (metastases at diagnosis or death from prostate cancer) and advanced (stage T4, N1, or M1 at diagnosis or death from prostate cancer), were determined from linkage to nationwide cancer registries through 2010. We conducted Cox proportional hazards regression adjusted for potential confounding variables. During 13 years of follow-up, we identified 785 cases of incident prostate cancer, including 118 lethal and 127 advanced cases. Four percent of men reported sleeping 5 h or less a night, and 2% reported sleeping 9 h or more per night. We found no association between sleep duration and risk of prostate cancer overall or for advanced/lethal disease. We also did not find an association between prostate cancer and sleep disruption, as defined by difficulty falling asleep, difficulty maintaining sleep, sleep quality, and restorative power of sleep.

Conclusions

In this large prospective study from Sweden, we found no association between habitual sleep duration or sleep disruption and risk of prostate cancer.

SUBMITTER: Markt SC

PROVIDER: S-EPMC4531408 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Insufficient Sleep and Risk of Prostate Cancer in a Large Swedish Cohort.

Markt Sarah C SC Grotta Alessandra A Nyren Olof O Adami Hans-Olov HO Mucci Lorelei A LA Valdimarsdottir Unnur A UA Stattin Pär P Bellocco Rino R Lagerros Ylva Trolle YT

Sleep 20150901 9

<h4>Study objective</h4>There are some data to suggest that insufficient sleep, including short sleep duration and sleep disruption, may be associated with an increased risk of cancer. We investigated the association between sleep duration and sleep disruption and risk of prostate cancer.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Sweden.<h4>Participants</h4>A total of 14,041 men in the Swedish National March Cohort.<h4>Interventions</h4>None.<h4>Measurements and results</h4>Habitual ...[more]

PMID: 26118562

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Project description:BackgroundExternal validation of risk calculators (RCs) is necessary to determine their clinical applicability beyond the setting in which these were developed.ObjectiveTo assess the performance of the Rotterdam Prostate Cancer RC (RPCRC) and the Prostate Biopsy Collaborative Group RC (PBCG-RC).Design setting and participantsWe used data from the prospective, population-based STHLM3 screening study, performed in 2012-2015. Participants with prostate-specific antigen ≥3 ng/ml who underwent systematic prostate biopsies were included.Outcome measurements and statistical analysisProbabilities for clinically significant prostate cancer (csPCa), defined as International Society of Urological Pathology grade ≥2, were calculated for each participant. External validity was assessed by calibration, discrimination, and clinical usefulness for both original and recalibrated models.Results and limitationsOut of 5841 men, 1054 (18%) had csPCa. Distribution of risk predictions differed between RCs; median risks for csPCa using the RPCRC and PBCG-RC were 3.3% (interquartile range [IQR] 2.1-7.1%) and 20% (IQR 15-28%), respectively. The correlation between RC risk estimates on individual level was moderate (Spearman's r = 0.55). Using the RPCRC's recommended risk threshold of ≥4% for finding csPCa, 36% of participants would get concordant biopsy recommendations. At 10% risk cut-off, RCs agreed in 23% of cases. Both RCs showed good discrimination, with areas under the curves for the RPCRC of 0.74 (95% confidence interval [CI] 0.72-0.76) and the PBCG-RC of 0.70 (95% CI 0.68-0.72). Calibration was adequate using the PBCG-RC (calibration slope: 1.13 [95% CI 1.03-1.23]), but the RPCRC underestimated the risk of csPCa (calibration slope: 0.73 [0.68-0.79]). The PBCG-RC showed a net benefit in a decision curve analysis, whereas the RPCRC showed no net benefit at clinically relevant risk threshold levels. Recalibration improved clinical benefit, and differences between RCs decreased.ConclusionsAssessment of calibration is essential to ensure the clinical value of risk prediction tools. The PBCG-RC provided clinical benefit in its current version online. On the contrary, the RPCRC cannot be recommended in this setting.Patient summaryPredicting the probability of finding prostate cancer on biopsy differed between two assessed risk calculators. After recalibration, the agreement of the models improved, and both were shown to be clinically useful.

Dataset Information

Insufficient Sleep and Risk of Prostate Cancer in a Large Swedish Cohort.

Study objective

Design

Setting

Participants

Interventions

Measurements and results

Conclusions

Publications

Insufficient Sleep and Risk of Prostate Cancer in a Large Swedish Cohort.

Similar Datasets

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