Abstract

Inflammatory Bowel Disease and the Risk of Prostate Cancer

Burns JA1, Weiner AB1, Catalona WJ1, Li EV1, Schaeffer EM1, Hanauer SB2, Strong S3, Burns J4, Hussain MHA5, Kundu SD6. Eur Urol. 2018 Dec 4. pii: S0302-2838(18)30938-2. doi: 10.1016/j.eururo.2018.11.039. [Epub ahead of print]
 
     

Author information

1 Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

2 Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

3 Division of Gastrointestinal Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

4 Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

5 Division of Hematology Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

6 Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: s-kundu@northwestern.edu.

Abstract

BACKGROUND: There are limited data examining the risk of prostate cancer (PCa) in patients with inflammatory bowel disease(IBD).

OBJECTIVE: To compare the incidence of PCa between men with and those without IBD.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, matched-cohort study involving a single academic medical center and conducted from 1996 to 2017. Male patients with IBD (cases=1033) were randomly matched 1:9 by age and race to men without IBD (controls=9306). All patients had undergone at least one prostate-specific antigen (PSA) screening test.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Kaplan-Meier and multivariable Cox proportional hazard models, stratified by age and race, evaluated the relationship between IBD and the incidence of any PCa and clinically significant PCa (Gleason grade group ≥2). A mixed-effect regression model assessed the association of IBD with PSA level.

RESULTS AND LIMITATIONS: PCa incidence at 10yr was 4.4% among men with IBD and 0.65% among controls (hazard ratio [HR] 4.84 [3.34-7.02] [3.19-6.69], p<0.001). Clinically significant PCa incidence at 10yr was 2.4% for men with IBD and 0.42% for controls (HR 4.04 [2.52-6.48], p<0.001). After approximately age 60, PSA values were higher among patients with IBD (fixed-effect interaction of age and patient group: p=0.004). Results are limited by the retrospective nature of the analysis and lack of external validity.

CONCLUSIONS: Men with IBD had higher rates of clinically significant PCa when compared with age- and race-matched controls.

PATIENT SUMMARY: This study of over 10000 men treated at a large medical center suggests that men with inflammatory boweldisease may be at a higher risk of prostate cancer than the general population.

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