Association between schizophrenia and prostate cancer risk: Results from a pool of cohort studies and Mendelian randomization analysis

Fan Ge; Zhenyu Huo; Yeling Liu; Xiaoqin Du; Rui Wang; Weiyi Lin; Runchen Wang; Jiana Chen; Yi Lu; Yaokai Wen; Huiying Cao; Siyue Shang; Md Eftekhar; Di Gu

Comprehensive Psychiatry (May 2022)

Association between schizophrenia and prostate cancer risk: Results from a pool of cohort studies and Mendelian randomization analysis

Fan Ge,
Zhenyu Huo,
Yeling Liu,
Xiaoqin Du,
Rui Wang,
Weiyi Lin,
Runchen Wang,
Jiana Chen,
Yi Lu,
Yaokai Wen,
Huiying Cao,
Siyue Shang,
Md Eftekhar,
Di Gu

Affiliations

Fan Ge: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Department of Clinical Medicine, First Clinical School, Guangzhou Medical University, Guangzhou 511436, China
Zhenyu Huo: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Department of Clinical Medicine, Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Yeling Liu: Department of Clinical Medicine, Third Clinical School, Guangzhou Medical University, Guangzhou 511436, China
Xiaoqin Du: Department for Communities, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
Rui Wang: Department of Clinical Medicine, First Clinical School, Guangzhou Medical University, Guangzhou 511436, China
Weiyi Lin: Department of Clinical Medicine, First Clinical School, Guangzhou Medical University, Guangzhou 511436, China
Runchen Wang: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Department of Clinical Medicine, Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Jiana Chen: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Department of Clinical Medicine, Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Yi Lu: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Department of Clinical Medicine, Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Yaokai Wen: Department of Clinical Medicine, Nanshan School, Guangzhou Medical University, Guangzhou 511436, China
Huiying Cao: Department of Psychology, Guangzhou Medical University, Guangzhou 511436, China
Siyue Shang: Department of Psychology, Guangzhou Medical University, Guangzhou 511436, China
Md Eftekhar: Department of Family Medicine, CanAm International Medical Center, Shenzhen 518067, China
Di Gu: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 511436, China; Guangdong Key Laboratory of Urology, Guangzhou Institute of Urology, Guangzhou 511436, China; Corresponding author at: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Journal volume & issue: Vol. 115
p. 152308

Abstract

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Background: Observational studies analyzing the risk of prostate cancer in schizophrenia patients have generated mixed results. We performed a meta-analysis and a Mendelian randomization (MR) analysis to evaluate the relationship and causality between schizophrenia and the risk of prostate cancer. Methods: A comprehensive and systematic search of cohort studies was conducted, and a random-effects model meta-analysis was performed to calculate the standardized incidence ratios (SIRs) for prostate cancer incidence among schizophrenia patients versus the general population. To investigate the correlation between genetically-predicted schizophrenia and prostate cancer risk, we used summary statistics from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium (61,106 controls and 79,148 cases), and 75 schizophrenia-associated single nucleotide polymorphisms (SNP) from European descent as the instrumental variable. Results: In the meta-analysis of 13 cohort studies with 218,076 men involved, a decreased risk of prostate cancer was observed among schizophrenia patients [SIR 0.610; 95% confidence interval (CI) 0.500–0.740; p < 0.001] with significant heterogeneity (I2 = 83.3%; p < 0.001). However, MR analysis did not sustain the link between genetically-predicted schizophrenia and prostate cancer [odds ratio (OR) 1.033; 95% CI 0.998–1.069; p = 0.065]. The result was robust against extensive sensitivity analyses. Conclusions: Our study indicated a decreased risk of prostate cancer in schizophrenia patients through meta-analysis, while MR analysis did not support the connection between schizophrenia and prostate cancer. Due to the interaction of genetic variants between binary exposures, we need to be cautious in interpreting and presenting causal associations. Moreover, further research is needed to investigate underlying factors that might link schizophrenia to the risk of prostate cancer.

Published in Comprehensive Psychiatry

ISSN: 0010-440X (Print); 1532-8384 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system: Psychiatry
Website: https://www.journals.elsevier.com/comprehensive-psychiatry

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