R O Roberts

Mayo Clinic - Rochester, Rochester, MN, United States

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Publications (20)60.22 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: PurposeBecause sex hormones are involved in the development of benign prostatic hyperplasia (BPH), we examined associations between polymorphisms in genes involved in androgen and estrogen metabolism and measures of BPH.MethodsA cohort of 510 community-dwelling Caucasian men (median age 60 years in 2000), randomly selected from the Olmsted County, MN population, participated in a longitudinal study of BPH. From 1990 through 2000, urologic measures of BPH were assessed biennially, including lower urinary tract symptom severity, peak urinary flow rates, prostate volume, and serum prostate specific antigen (PSA) level. Acute urinary retention and treatment for BPH were assessed from community medical records. Men were genotyped for candidate genes involved in androgen and estrogen metabolism.ResultsWith the wildtype genotype as reference, significant associations (p < 0.01) were observed between HSD3B1 AC heterozygous genotype and risk of an enlarged prostate (Hazard Ratio (HR) = 0.7, 95% Confidence intervals (CI) = 0.6, 0.9), CYP19 genotype homozygous for ≥ 175 TTTA repeats and an enlarged prostate (HR = 1.5, 95% CI = 1.1, 2.1), CYP19 homozygous variant TT genotype and an enlarged prostate (HR = 1.6, 95% CI = 1.1, 2.2). ARE1 (-252 G_A) homozygous AA genotype was associated with medical treatment for BPH (HR = 2.3, 95% CI = 1.2, 4.4). The risk (HR, 95% CI) of an enlarged prostate was increased in men with 2 high risk genotypes for HSD3B1 (1.4 [1.0, 1.8]) and CYP19 (1.8 [1.3, 2.3]) and ≥2 high risk ARE1 genotypes was associated with an increased risk of treatment for BPH (2.9 [1.4, 5.8]).ConclusionThese findings suggest possible associations between HSD3B1, CYP19, and ARE1 gene polymorphisms and measures of BPH. While no one polymorphism is associated uniformly across surrogate measures of BPH, these data suggest that further examination of these genes for their potential role in the etiology, diagnosis, prevention, or treatment of BPH may be warranted.
    Annals of Epidemiology 09/2005; DOI:10.1016/j.annepidem.2005.06.028 · 2.15 Impact Factor
  • Annals of Epidemiology 09/2004; 14(8):616-616. DOI:10.1016/j.annepidem.2004.07.067 · 2.15 Impact Factor
  • Annals of Epidemiology 09/2004; 14(8):599-600. DOI:10.1016/j.annepidem.2004.07.022 · 2.15 Impact Factor
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    ABSTRACT: The objectives of the study were to characterize male sexual functioning as related to age in community-dwelling older men. In 1989, a random sample of men aged 40-79 y (n=2115) without prior prostate surgery, prostate cancer, or other conditions known to affect voiding function (except benign prostatic hyperplasia) was invited (55% agreed) to participate in the Olmsted County Study of Urinary Symptoms and Health Status Among Men. In 1996, a previously validated male sexual function questionnaire was administered to the cohort. The questionnaire has 11 questions measuring sexual drive (two questions); erectile function (three) and ejaculatory function (two), as well as assessing problems with sex drive, erections, or ejaculation (three); and overall satisfaction with sex life (one). Each question is scored on a scale of 0-4, with higher scores indicating better functioning. Cross-sectional age-specific means (+/-s.d.) for drive, erections, ejaculation, problems, and overall satisfaction declined from 5.2 (+/-1.5), 9.8 (+/-2.5), 7.4 (+/-1.4), 10.7 (+/-2.2), and 2.6 (+/-1.0), respectively, for men in their 40s to 2.4 (+/-1.6), 3.3 (+/-3.4), 3.6 (+/-3.2), 7.7 (+/-3.8), and 2.1 (+/-1.2) for men 70 y and older (all P<0.001). The cross-sectional decline in function with age was not constant, with age-related patterns differing by domain. The percentage of men reporting erections firm enough to have intercourse in the past 30 days declined from 97% (454/468) among those in their 40s to 51% (180/354) among those in their 80s (P&<0.001). In age-adjusted analyses, men reporting regular sexual partners had statistically significantly higher levels of sex drive, erectile function, ejaculatory function, and overall satisfaction than those who did not report regular sexual partners. Sexual drive, erectile functioning, ejaculatory functioning, and overall sexual satisfaction in men show somewhat differing cross-sectional patterns of decline with advancing age. Active sexual functioning is maintained well into the 80s in a substantial minority of community-dwelling men.
    International Journal of Impotence Research 06/2003; 15(3):185-91. DOI:10.1038/sj.ijir.3900996 · 1.37 Impact Factor
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    ABSTRACT: To obtain community-based information about the incidence of interstitial cystitis, a chronic disabling condition of the bladder where knowledge is limited because there are no definitive diagnostic criteria. All residents of Olmsted County, MN, USA who had received a physician-assigned diagnosis of interstitial cystitis between 1976 and 1996 were identified through the resources of the Rochester Epidemiology Project. The clinical findings at diagnosis and during the follow-up were ascertained from the community medical records for each study subject. In all, 16 women and four men received a diagnosis of interstitial cystitis during the study period. The overall age- and sex-adjusted (95% confidence interval) incidence rate was 1.1 (0.6-1.5) per 100 000 population. The age-adjusted incidence rates were 1.6 per 100 000 in women and 0.6 per 100 000 in men (P = 0.04). The median (range) age at initial diagnosis was 44.5 (27-76) years in women and 71.5 (23-79) years in men (P = 0.26). The median number of episodes of care-seeking for symptoms before the diagnosis was one for women and 4.5 for men (P = 0.03). The median duration from the onset of symptoms until the first diagnosis was 0.06 and 2.2 years in women and men, respectively (P = 0.2). These findings suggest that the incidence of interstitial cystitis in the community is extremely low. Although the gender difference may be real, the trend toward a later diagnosis in men than in women suggests a potential for missed diagnosis in men. This might explain some of the gender difference in the incidence of interstitial cystitis in men and women.
    BJU International 03/2003; 91(3):181-5. DOI:10.1046/j.1464-410X.2003.04060.x · 3.13 Impact Factor
  • European Urology Supplements 02/2003; 2(1):26-26. DOI:10.1016/S1569-9056(03)80103-3 · 3.37 Impact Factor
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    R O Roberts, S J Jacobsen
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    ABSTRACT: Alcohol consumption and cigarette smoking were evaluated in relation to development of benign prostatic hyperplasia (BPH) among 29,386 members of the Health Professionals Follow-up Study. Men who were 40-75 years old in 1986 and free of prior BPH surgery, diagnosed cancer at baseline, and prostate cancer at baseline and during follow-up were followed for incidence of BPH surgery from 1986 to 1994. Cases were men who reported BPH surgery between 1986 and 1994 (n = 1,813) or who scored £15 points of 35 on seven lower urinary tract symptom questions modified from the American Urological Association symptom index in 1992 and 1994 (n = 1,786); noncases were men who scored ^7 points (n = 20,840). After controlling for age, race/ethnicity, body mass index, physical activity, and mutually for alcohol intake and smoking, moderate alcohol consumption was inversely related with total BPH (30.1-50 g/day vs. 0: odds ratio (OR) = 0.59, 95% confidence interval (Cl) 0.51-0.70; p trend < 0.0001), although the relation was attenuated at high intake (£50.1 g/day vs. 0: OR = 0.72, 95% Cl 0.57-0.90). Current cigarette smoking was positively related to total BPH only among those who smoked 35 or more cigarettes/day (compared with never smokers: OR = 1.45, 95% Cl 1.07-1.97). These findings suggest that moderate alcohol consumption and avoidance of smoking may benefit BPH. Am J Epidemiol 1999;149:106-15. alcohol drinking; cohort studies; prostatectomy; prostatic hyperplasia; risk factors; smoking
    American Journal of Epidemiology 09/1999; 150(3):321-2. DOI:10.1093/oxfordjournals.aje.a010005 · 4.98 Impact Factor
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    ABSTRACT: To assess the prevalence of combined fecal and urinary incontinence. A cross-sectional, community-based study. Olmsted County, Minnesota. Men (n = 778) and women (n = 762), aged 50 years or older, selected randomly from the population. Participants completed a previously validated self-administered questionnaire that assessed the occurrence of fecal and urinary incontinence in the previous year. The age-adjusted prevalence of incontinence was 11.1% (95% Confidence Interval (CI), 8.8-13.5) in men and 15.2% (95% CI, 12.5-17.9) in women for fecal incontinence; 25.6% (95% CI, 22.5-28.8) in men and 48.4% (95% CI, 44.7-52.2) in women for urinary incontinence; and 5.9% (95% CI, 4.1-7.6) in men and 9.4% (95% CI, 7.1-11.6) in women for combined urinary and fecal incontinence. The prevalence of fecal incontinence increased with age in men but not in women, from 8.4% among men in their fifties to 18.2% among men in their eighties (P for trend = .001). For women, the prevalence increased from 13.1% among 50-year-old women to 20.7% among women 80 years or older (P for trend = .5). Among persons with fecal incontinence, the prevalence of concurrent urinary incontinence was 51.1% among men and 59.6% among women (P = .001 and P = .003, respectively). Cross-sectionally, the age-adjusted, relative odds of fecal incontinence among persons with urinary incontinence was greater in men than in women (Odds Ratio (OR) = 3.0; 95% CI, 1.9-4.8 in men and OR = 1.8; 95% CI, 1.2-2.7 in women, P = .04). These findings suggest that persons with one form of incontinence are likely to have the other form as well. Despite the higher prevalence of urinary and fecal incontinence among women, the association between fecal incontinence and urinary incontinence was stronger among men than women. This finding, and the significant association between fecal incontinence and age observed in men but not in women, suggest that the etiologies may be more closely linked in men than in women.
    Journal of the American Geriatrics Society 08/1999; 47(7):837-41. · 4.22 Impact Factor
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    ABSTRACT: To investigate the association of benign prostatic enlargement and health-related quality of life (HRQoL) assessed by validated questionnaires. Randomly selected men (n = 471) aged 40-79 years from Olmsted County, Minn. (USA) without prior prostate surgery or prostate cancer had a full urologic workup, including transrectal ultrasonography, in addition to completing questionnaires soliciting information about urinary symptom frequency, bother, degree of interference with daily activities and other measures of HRQoL. Disease-specific HRQoL was worse in older men, and men with more severe symptoms. Age-adjusted mean scores for symptom severity, bother and activity interference were about 50% worse for men with enlarged prostates (volume > 40 cm3). After adjusting for age, men with enlarged prostates were nearly 3 times (95% CI 1.6, 5.1) as likely to have moderate to severe symptoms, and about twice as likely to have bother (odds ratio 2.4; 95% CI 1.3, 4.2) or activity interference (odds ratio 1.8; 95% CI 1. 0, 3.2) relative to men with smaller prostates. HRQoL measures are worse in men who are older and, after adjusting for age, in men with increased urinary symptom frequency and enlarged prostate. The broader spectrum of patients provided by the community-based random sampling allows elucidation of these important relationships.
    European Urology 04/1999; 35(4):277-84. DOI:10.1159/000019861 · 12.48 Impact Factor
  • The Journal of Urology 01/1999; DOI:10.1097/00005392-199901000-00146 · 3.75 Impact Factor
  • RO Roberts, SJ Jacobsen, WT Reilly
    Southern Medical Journal 01/1999; 92(11):1111-1112. DOI:10.1097/00007611-199911000-00023 · 1.12 Impact Factor
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    ABSTRACT: Barriers to prenatal care have been extensively investigated in low-income and inner-city communities. Less attention has been directed to the study of prenatal care among middle- and upper-class pregnant women. This study describes perceived barriers and factors associated with late initiation of prenatal care in a predominantly middle- to upper-class midwestern community. Consenting women in Olmsted County, Minnesota, who were attending a clinic for their first obstetric visit completed a self-administered questionnaire that queried the presence of factors making it difficult to receive prenatal care, perception about the importance of prenatal care, expectations at the first prenatal care visit, and sociodemographic factors. Of the 813 women aged 14 to 47 years, 692 (86%) had their first prenatal visit within the first trimester of pregnancy. Only 98 (12%) women reported external barriers to receiving prenatal care. These factors included difficulty in getting an appointment (46.9%), problems finding child care (26.5%), and lack of transportation (14.3%). In multivariable logistic regression analyses, late initiation of care was associated with patient perception of prenatal care as being less than very important (odds ratio [OR] = 4.1, 95% confidence interval [CI], 1.7-9.7); external barriers to prenatal care (OR = 2.9, 95% CI, 1.6-5.4); annual income < $17,000 (OR = 2.9, 95% CI, 1.5-5.7); and an unintended pregnancy (OR = 2.1, 95% CI, 1.3-3.5). Multiparous women and women older than 35 years were more likely to perceive prenatal care as less than very important (OR = 3.9, 95% CI, 2.5-14.6 and OR = 2.9, 95% CI, 1.2-6.8, respectively). These findings suggest that perceptions about the importance of prenatal care may play a greater role in the initiation of care among this group of women than is recognized. Women with more experience with pregnancy appear to place slightly less importance on prenatal care.
    The Journal of family practice 07/1998; 47(1):53-61. · 0.74 Impact Factor
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    ABSTRACT: To estimate the prevalence of urinary incontinence and to assess care-seeking behavior for urinary symptoms among community-dwelling people. A community-based cross-sectional study. Randomly selected men and women from Olmsted County, Minnesota. Two cohorts, one comprised of both men (n = 778) and women (n = 762) 50 years of age or older and a second comprised of men aged 40 years or older (n = 2150). Participants completed questionnaires assessing urinary incontinence in the previous 12 months, the number of days leaked, the amount leaked, and healthcare-seeking measures for urinary symptoms. In the first cohort, the prevalence of incontinence was 24% in men and 49% in women; 29% of men and 13% of women with incontinence had sought care for urinary symptoms. Urinary incontinence was more strongly associated with care-seeking measures for urinary symptoms in men (Odds Ratio (OR) = 4.3, 95% Confidence Interval (CI) = 2.4, 8.0) than in women (OR = 2.1, 95% CI = 1.2, 3.9). Moderate or severe urinary incontinence was associated significantly with care-seeking for urinary symptoms (OR = 10.5, 95% CI = 5.6, 19.8). In the second cohort, the prevalence of urinary incontinence was 17.3%; 8.5% of men with incontinence had sought care for urinary symptoms. Men with incontinence were 1.2 times (95% CI = .8, 1.9) as likely to seek care for urinary symptoms as men without incontinence. Our findings indicate that although urinary incontinence is relatively common in the community, care-seeking for urinary symptoms among persons with urinary incontinence is low, particularly among women, for whom the prevalence exceeds 40% between the ages of 50 and 70 years. These findings suggest that strategies to promote care-seeking for incontinence need to be investigated and employed in the community.
    Journal of the American Geriatrics Society 05/1998; 46(4):467-72. DOI:10.1097/00005392-199812010-00126 · 4.22 Impact Factor
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    ABSTRACT: To describe the occurrence of a physician-assigned diagnosis of prostatitis in a community-based cohort. A sampling frame of all Olmsted County, Minnesota, male residents was used to randomly select a cohort of men between 40 and 79 years old by January 1, 1990, to participate in a longitudinal study of lower urinary tract symptoms. The 2115 participants (response rate 55%) completed a previously validated self-administered questionnaire that assessed the prevalence of lower urinary tract symptoms, including a history of prostatitis. Subsequently, all inpatient and outpatient community medical records of participants were reviewed retrospectively for a physician-assigned diagnosis of prostatitis from the date of initiation of the medical record through the date of the last follow-up. The overall prevalence rate of a physician-assigned diagnosis of prostatitis was 9%. Men identified with the diagnosis of "prostatitis" had symptoms of dysuria and frequency and rectal, perineal, suprapubic, and lower back pain. Among men with a previous diagnosis of prostatitis, the cumulative probability of subsequent episodes of prostatitis was much higher (20%, 38%, and 50% among men 40, 60, and 80 years old, respectively). These findings indicate that the community-based prevalence of a physician-assigned diagnosis of prostatitis is high, of similar magnitude to that of ischemic heart disease and diabetes. Furthermore, once a man has an initial episode of prostatitis, he is more likely to suffer chronic episodes than men without a diagnosis. Although the pathologic mechanisms underlying these diagnoses are not certain, these data provide a first step toward understanding how frequently the diagnosis occurs in the community.
    Urology 05/1998; 51(4):578-84. DOI:10.1016/S0022-5347(01)62187-6 · 2.13 Impact Factor
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    ABSTRACT: We determined the occurrence of and risk factors for acute urinary retention in the community setting. A cohort of 2,115 men 40 to 79 years old was randomly selected from an enumeration of the Olmsted County, Minnesota population (55% response rate). Participants completed a previously validated baseline questionnaire that assessed symptom severity, and voided into a portable urometer to measure peak urinary flow rates. A 25% random subsample underwent transrectal sonographic imaging of the prostate to determine prostate volume. Followup was performed through a retrospective review of community medical records to determine the occurrence of acute urinary retention in the subsequent 4 years. During the 8,344 person-years of followup 57 men had a first episode of acute urinary retention (incidence 6.8/1,000 person-years, 95% confidence interval [CI] 5.2, 8.9). Among men with no to mild symptoms (American Urological Association symptom index score 7 or less) the incidence of acute urinary retention increased from 2.6/1,000 person-years among men 40 to 49 years old to 9.3/1,000 person-years among men 70 to 79 years old. By contrast, rates increased from 3.0/1,000 person-years for men 40 to 49 years old to 34.7/1,000 person-years among men 70 to 79 years old among men with moderate to severe symptoms (American Urological Association symptom index score greater than 7). Men with depressed peak urinary flow rate (less than 12 ml. per second) were at 4 times the risk of acute urinary retention compared with men with urinary flow rates greater than 12 ml. per second (95% CI 2.3, 6.6). Men with an enlarged prostate (greater than 30 ml.) experienced a 3-fold increase in risk (95% CI 1.0, 9.0, p = 0.04). Lower urinary tract symptoms, depressed peak urinary flow rates, enlarged prostates and older age are associated with an increased risk of acute urinary retention in community dwelling men. These findings may help to identify men at increased risk of acute urinary retention in whom closer evaluation may be warranted.
    The Journal of Urology 09/1997; 158(2):481-7. · 3.75 Impact Factor
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    ABSTRACT: To investigate factors associated with a high propensity to seek care. Cross-sectional baseline component of a prospective cohort study. Olmsted County, Minnesota. A randomly selected, community-based cohort of 2115 men aged 40 to 79 years on January 1, 1990. Participants completed a questionnaire that elicited information about the propensity to seek care by means of 7 hypothetical scenarios about physical illness. Also queried was the self-reported outpatient physician utilization in the previous year and sociodemographic factors. There was a significant association between propensity to seek care and physician utilization. Men with a high propensity to seek care were more likely to have had 4 or more physician visits (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.3-2.3). Bivariate analysis suggested significant associations between a propensity to seek care for physical reasons and retirement (OR, 2.0; 95% CI, 1.1-2.6), age of 65 years or more (OR, 1.9; 95% CI, 1.5-2.4), incomplete high school education (OR, 1.6; 95% CI, 1.1-2.2), and an annual income of less than $25,000 (OR, 1.4; 95% CI, 1.1-1.9). Multivariable logistic regression analysis demonstrated that retired men were more likely to have a high propensity to seek care (OR, 1.7; 95% CI, 1.2-2.4), with the other variables no longer-being significant. Our findings suggest an association between propensity to seek care and physician utilization and retirement. In view of the increasing numbers of aged persons in the United States, this relatively higher propensity to seek health care among retired men may have a greater impact on the cost of health care for the aged than is fully appreciated.
    Archives of Family Medicine 05/1997; 6(3):218-22. DOI:10.1001/archfami.6.3.218
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    ABSTRACT: The purpose of this study was to examine the association between cigarette smoking and prostatism among Japanese men. Male residents of Shimamaki-mura, Japan, aged 40-79 years old (n = 286), completed a self-administered questionnaire that included the international prostate symptom score (IPSS). A detailed cigarette smoking history was also obtained. All men had a transrectal ultrasonographic estimate of prostatic volume and a peak urinary flow rate measurement. Current cigarette smoking was inversely associated with an impaired peak urinary flow rate (< 15 mL/sec) (odd ratio [OR] = 0.39, 95% confidence interval [CI] = 0.18, 0.84), and with moderate to severe symptoms (IPSS > 7) (OR = 0.84, 95% CI = 0.48, 1.49), but was not significantly associated with prostatic volume. Smokers of 1 to 1.4 packs a day were less likely and smokers of less than a pack a day or 1.5 or more packs a day were more likely to have moderate to severe symptoms and a greater prostatic volume. These findings suggest that cigarette smoking may have a protective effect on prostatism at certain smoking intensities, but no effect or a deleterious effect at other intensities.
    The Prostate 02/1997; 30(3):154-9. · 3.57 Impact Factor
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    ABSTRACT: Baseline measurements for a population-based prospective cohort study were used to assess the association between family history of enlarged prostate and urinary symptoms. Between December 1989 and March 1991, a group of randomly selected men aged 40-79 years from Olmsted County, Minnesota, was administered a previously validated questionnaire that included questions with wording close to that of the American Urological Association's Symptom Index. A detailed family history of an enlarged prostate was obtained by personal interview, and peak urinary flow rates were measured for each participant. Of the 2,119 men, 440 (21 percent) reported a family history of an enlarged prostate. The age-adjusted odds of having moderate or severe urinary symptoms were elevated among those with a family history relative to those without (odds ratio = 1.3, 95 percent confidence interval 1.1-1.7). With simultaneous control for effects of age and worry about urologic function, the odds ratio remained at 1.3 (95 percent confidence interval 1.0-1.6). Furthermore, this risk was greater for men with relatives diagnosed at a younger age (odds ratio = 2.5, 95 percent confidence interval 1.5-4.3). Men with a family history were also 1.3 times as likely to have an impaired peak urinary flow rate. These findings suggest that men with a family history of an enlarged prostate may be at increased risk for development of symptoms and signs suggestive of benign prostatic hyperplasia and that this risk is greater in men with relatives diagnosed at a younger age. Recognition of this association may help to target early interventions and may lead to further clues about the causes of benign prostatic hyperplasia.
    American Journal of Epidemiology 12/1995; 142(9):965-73. · 4.98 Impact Factor
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    Roberts RO, Lieber MM, Rhodes T
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    Roberts RO, Jacobson DJ
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    ABSTRACT: (CI), 0.28 to 0.73) among NSAID users compared with nonusers. In person-year analyses, the incidence of prostate cancer was 8.4 per 1000 person-years and 18.5 per 1000 person- years in NSAID users and nonusers, respectively. This associ- ation directly correlated with increasing age. For NSAID users aged 50 to 59 years, 60 to 69 years, and 70 to 79 years, the relative odds of prostate cancer were 0.88 (95% CI, 0.36 to 2.18), 0.4 (95% CI, 0.19 to 0.82), and 0.17 (95% CI, 0.06 to 0.45), respec- tively. Also, the proportion of men who used NSAIDs in- creased with age, with 54% of those aged 70 to 79 years on daily NSAIDs. Among all NSAID users, 77% were taking aspirin alone. There was no association between self-reported family history of prostate cancer and the development of prostate cancer. At baseline, NSAID users had a statistically dispropor- tionate share of benign prostatic hyperplasia (60% of users versus 44% of nonusers), prostatitis (11% versus 7%), diabetes (10% versus 4.4%), and history of myocardial infarction (MI) (36% versus 8%). In the year prior to enrollment, NSAID users had more physician visits (54% users versus 38% non- users), prostate-specific antigen (PSA) determinations (medi- an, 1 versus 0), and digital rectal exams (4% versus 3%). More nonusers withdrew and were lost to follow-up (5% versus 9%). In a model adjusting for age, urologic disease, comor- bidities, and physician visits in the year prior to enrollment, the relative odds of the association between prostate cancer and NSAID use were 0.37 (95% CI, 0.22 to 0.62). Conclusion . Daily use of NSAIDs may be associated with a lower incidence of prostate cancer in men 60 years or older.

Publication Stats

911 Citations
60.22 Total Impact Points

Institutions

  • 1997–2005
    • Mayo Clinic - Rochester
      • • Department of Laboratory Medicine & Pathology
      • • Department of Health Science Research
      Rochester, MN, United States
  • 1999
    • Merck
      • Epidemiology
      Whitehouse Station, NJ, United States