Background: Elevated plasma testosterone levels are thought to play a role in the male preponderance of cases of Brugada syndrome (BS) and the development of prostate cancer.
Methods and results: The 34 Brugada-like electrocardiogram (ECG) cases were identified among 2,681 male survivors of the atomic bomb who had undergone at least 1 biennial health examination between July 1958 and December 1999 in Nagasaki, Japan. They were followed for incident prostate cancer from July 1958 through December 2004, and the risk of prostate cancer for Brugada-like ECG, age, smoking habit, and radiation exposure was analyzed using Cox proportional hazards analysis. Among the men with or without Brugada-like ECG there were 4 (11.8%) and 54 (2.0%) cases of prostate cancer, respectively. With age adjustment there was a higher risk of prostate cancer for Brugada-like ECG (relative risk (RR): 5.42, 95% confidence interval (CI) 1.96-15.00, P=0.001). With further adjustment for smoking habit and radiation dose, Brugada-like ECG remained a significant risk factor for prostate cancer (RR: 6.47, 95%CI 1.97-21.21, P=0.002).
Conclusions: Brugada-like ECG confers a higher risk of prostate cancer independent of age, smoking habit, and radiation exposure. Men with a Brugada-like ECG should be regularly examined for prostate cancer and vice versa, especially elderly subjects.