Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Dr. Xiaomei Ma

Second Advisor

Dr. Rong Wang


Background: Previous studies evaluating the risk of cardiovascular diseases (CVD) in prostate cancer patients receiving androgen deprivation treatment (ADT) often did not distinguish different types of ADT.

Methods: We conducted a large, retrospective cohort study using the linked Surveillance, Epidemiology and End Results - Medicare database, including patients with primary localized prostate cancer diagnosed in 2007--2013 and followed through the end of 2014. Time dependent multivariable Cox proportional hazards models with death as the competing risk were used to evaluate the association between ADT (overall, and two subtypes: gonadotropin-releasing hormone [GnRH] agonists and oral antiandrogens) and incidence of CVD.

Results: Among 20,239 prostate cancer patients, 32% received ADT. Receipt of ADT was associated with a 28% increase in the risk of CVD (hazard ratio [HR] = 1.28, 95% confidence interval [CI]: 1.14-1.67). The HRs for GnRH agonists and oral antiandrogens were 1.22 (95% CI: 1.15-1.30) and 1.11 (95% CI: 1.04-1.20), respectively.

Conclusions: In patients with primary, localized prostate cancer, ADT is associated with a significantly increased risk for CVD, and the magnitude of association appears higher for GnRH agonists than for oral antiandrogens.

Open Access

This Article is Open Access

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