Hyperprolactinemia and cancer risk: a Swedish population-based cohort study

Objective: Prolactin (PRL) promotes cell proliferation, and PRL receptor expression is elevated in various cancer types. However, only a few studies have examined cancer risk in patients with hyperprolactinemia (HPL). The aim of this study was to investigate cancer risk in a nationwide cohort of pat...

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Main Authors: Christos Himonakos, Louise Emilsson, Sophie Bensing, Katarina Berinder
Format: Article
Language:English
Published: Bioscientifica 2025-06-01
Series:Endocrine Connections
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Online Access:https://ec.bioscientifica.com/view/journals/ec/14/6/EC-25-0108.xml
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author Christos Himonakos
Louise Emilsson
Sophie Bensing
Katarina Berinder
author_facet Christos Himonakos
Louise Emilsson
Sophie Bensing
Katarina Berinder
author_sort Christos Himonakos
collection DOAJ
description Objective: Prolactin (PRL) promotes cell proliferation, and PRL receptor expression is elevated in various cancer types. However, only a few studies have examined cancer risk in patients with hyperprolactinemia (HPL). The aim of this study was to investigate cancer risk in a nationwide cohort of patients with a diagnosis of HPL, with special emphasis on breast cancer. Design: In this Swedish population-based cohort study, we used nationwide registries to identify 3,837 patients (2,955 (77%) women) with HPL, treated with dopamine agonists (DA), diagnosed between 2006 and 2019, along with 38,370 controls matched by age, sex, calendar year and county of residence at first HPL diagnosis. Methods: Cancer outcomes (overall and specific types), as registered in the Swedish Cancer Register, were analyzed using Cox regression, internally stratified by the matching variables and additionally adjusted for diabetes mellitus, obesity, smoking, alcohol overconsumption, hormone replacement therapy and educational level to estimate adjusted hazard ratios (aHRs). Results: During a median follow-up time of 6.1 years (interquartile range (IQR) 3.4–9.6), 168 (4.6%) new cases of cancer were identified in patients with HPL and 1,608 (4.4%) in the control group (aHR 1.05 (95% CI: 0.89–1.23)). Twenty-eight (0.7%) patients (all women) in the HPL group and 267 (0.7%) in the control group developed breast cancer (aHR 1.02 (95% CI: 0.68–1.51)). Similarly, there was no increased risk of any other site-specific cancer. Conclusions: In this nationwide cohort study of patients with DA-treated HPL, no increased risk of overall cancer, breast cancer or other site-specific malignancies was observed.
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spelling doaj-art-7af7af89b2e94c7f8b436d43ff5fe4482025-08-20T03:23:37ZengBioscientificaEndocrine Connections2049-36142025-06-0114610.1530/EC-25-01081Hyperprolactinemia and cancer risk: a Swedish population-based cohort studyChristos Himonakos0Louise Emilsson1Sophie Bensing2Katarina Berinder3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenDepartment of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, SwedenObjective: Prolactin (PRL) promotes cell proliferation, and PRL receptor expression is elevated in various cancer types. However, only a few studies have examined cancer risk in patients with hyperprolactinemia (HPL). The aim of this study was to investigate cancer risk in a nationwide cohort of patients with a diagnosis of HPL, with special emphasis on breast cancer. Design: In this Swedish population-based cohort study, we used nationwide registries to identify 3,837 patients (2,955 (77%) women) with HPL, treated with dopamine agonists (DA), diagnosed between 2006 and 2019, along with 38,370 controls matched by age, sex, calendar year and county of residence at first HPL diagnosis. Methods: Cancer outcomes (overall and specific types), as registered in the Swedish Cancer Register, were analyzed using Cox regression, internally stratified by the matching variables and additionally adjusted for diabetes mellitus, obesity, smoking, alcohol overconsumption, hormone replacement therapy and educational level to estimate adjusted hazard ratios (aHRs). Results: During a median follow-up time of 6.1 years (interquartile range (IQR) 3.4–9.6), 168 (4.6%) new cases of cancer were identified in patients with HPL and 1,608 (4.4%) in the control group (aHR 1.05 (95% CI: 0.89–1.23)). Twenty-eight (0.7%) patients (all women) in the HPL group and 267 (0.7%) in the control group developed breast cancer (aHR 1.02 (95% CI: 0.68–1.51)). Similarly, there was no increased risk of any other site-specific cancer. Conclusions: In this nationwide cohort study of patients with DA-treated HPL, no increased risk of overall cancer, breast cancer or other site-specific malignancies was observed.https://ec.bioscientifica.com/view/journals/ec/14/6/EC-25-0108.xmlhyperprolactinemiacancer riskbreast cancerdopamine agonistsprolactinoma
spellingShingle Christos Himonakos
Louise Emilsson
Sophie Bensing
Katarina Berinder
Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
Endocrine Connections
hyperprolactinemia
cancer risk
breast cancer
dopamine agonists
prolactinoma
title Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
title_full Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
title_fullStr Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
title_full_unstemmed Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
title_short Hyperprolactinemia and cancer risk: a Swedish population-based cohort study
title_sort hyperprolactinemia and cancer risk a swedish population based cohort study
topic hyperprolactinemia
cancer risk
breast cancer
dopamine agonists
prolactinoma
url https://ec.bioscientifica.com/view/journals/ec/14/6/EC-25-0108.xml
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AT katarinaberinder hyperprolactinemiaandcancerriskaswedishpopulationbasedcohortstudy