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Use of weight loss medications in relation with prostate, colorectal and male breast cancers among older men: SEER-Medicare 2007–2015

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Abstract

Background

The association of weight loss medications with prostate (PCa), colorectal (CRC) or male breast cancers, including assessment of these cancers combined (HRCs, hormone-associated cancers) remain poorly understood. Testosterone replacement therapy (TTh) is reported to be inversely associated with obesity, PCa and CRC, but it is unclear whether TTh modifies the association of weight loss medications with HRCs.

Methods

In 49,038 men (≥ 65 years) of SEER-Medicare, we identified 15,471 men diagnosed with PCa, 4836 with CRC, and 141 with male breast cancers. Pre-diagnostic prescription of weight loss medications and TTh was ascertained for this analysis. Weighted multivariable-adjusted conditional logistic and Cox proportional hazards (mortality) models were conducted.

Results

We found an inverse association between use of weight loss medications and incident PCa (OR 0.59, 95% CI 0.57–0.62), CRC (OR 0.86, 95% CI 0.80–0.92), and HRCs (OR 0.65, 95% CI 0.62–0.68). Similar associations were observed for advanced stage at diagnosis of PCa and CRC. Effects of weight loss medications on PCa and HRC remained significant irrespective of the use of TTh but were only suggestive with CRC with positive TTh use. No associations were observed with male breast cancer and HRCs mortality.

Conclusion

Pre-diagnostic use of weight loss medications reduced the incidence of PCa, CRC, and HRCs. These associations persisted in the same direction irrespective of the history of TTh use. Future studies are needed to confirm these findings and to identify underlying biological mechanisms of weight loss medications and TTh on the risk of cancer.

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Data availability

The authors confirm that data used in developing this article are available upon reasonable request to the corresponding author.

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Acknowledgements

The collection of cancer incidence data used in this study was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors.

Funding

David S. Lopez was supported by the National Institutes of Health (NIH) and National Institute on Aging, Grant #: P30 AG059301; and Cancer Prevention and Research Institute of Texas (CPRIT), Grant #: RP210130.

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Author notes

  1. Steven Canfield and Yong-Fang Kuo have equally contributed as the senior authors.

Authors and Affiliations

  1. School of Public and Population Health, The University of Texas Medical Branch (UTMB), 301 University Blvd., Galveston, TX, 77555-1153, USA

    David S. Lopez, Hyunkyoung Kim, Efstathia Polychronopoulou, Alejandro Villasante-Tezanos, Jacques Baillargeon & Yong-Fang Kuo

  2. Instituto Nacional de Salud Publica, Mexico City, Mexico

    Luisa E. Torres-Sanchez

  3. Division of Urology, UTHealth McGovern Medical School, Houston, TX, USA

    Steven Canfield

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Contributions

DSL, YFK, HK, EP, SC: conception and design, and writing original draft. DSL, HK, YFK: methodology and statistical analysis. DSL, KH, EP, YFK: interpretation of data, statistical analysis, biostatistics, and computational analysis. All the authors: interpretation, writing review and editing.

Corresponding author

Correspondence to David S. Lopez.

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Conflict of interest

The authors declare no potential conflicts of interest. This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.

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The secondary data analysis was approved by Institutional Review Board at the UTMB, Galveston, TX.

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Lopez, D.S., Kim, H., Polychronopoulou, E. et al. Use of weight loss medications in relation with prostate, colorectal and male breast cancers among older men: SEER-Medicare 2007–2015. J Cancer Res Clin Oncol 149, 8255–8265 (2023). https://doi.org/10.1007/s00432-023-04778-z

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