The study “Inflammatory Bowel Disease and the Risk of Prostate Cancer” was published in the journal European Urology.
Inflammatory bowel disease (IBD), whether Crohn’s disease and ulcerative colitis (its two main types), is marked by chronic inflammation of the gastrointestinal tract. Such inflammation has been associated with the higher risk of cancer in the digestive tract, although a possible link between IBD and prostate cancer is not well-studied.
Prostate-specific antigen (PSA) levels are used as a diagnostic test for prostate cancer. Data available to date has not compared PSA levels in men with IBD and those without this disease, the authors wrote.
Researchers at the Northwestern Medicine reviewed the medical records of 1,033 men with IBD and 9,306 non-IBD who were treated in its network between July 1996 and June 2014. All had undergone at least one PSA screening test, with patients grouped into 10-year age ranges.
The median follow-up time for IBD patients was 6.5 years and 4.7 years for those in the control group.
At the five-year follow-up mark, prostate cancer cases were reported in 2.8% of the IBD patients while its incidence was 0.25% of the control group. A similar trend was observed at the 10-year mark, with 4.4% of IBD patients showing the cancer, compared to 0.65% in those without this disease.
The occurrence of clinically significant prostate cancer — defined by a Gleason score of 7 or higher and requiring treatment — was also about four to five times higher in IBD patients than in the control group.
No significant relationship was seen between IBD type and a prostate cancer diagnosis.
A trend toward higher PSA values among IBD patients was seen, and those men with IBD who were older than age 60 had significantly higher levels of PSA compared to the controls.
Although elevated PSA levels could be related to the inflammation, “these patients may need to be screened more carefully than a man without inflammatory bowel disease,” Shilajit Kundu, MD, lead study author and chief of urologic oncology at Northwestern University Feinberg School of Medicine said in a press release.
“If a man with inflammatory bowel disease has an elevated PSA, it may be an indicator of prostate cancer,” he added.
“These findings highlight the important role of investigating the benefits and harms of [prostate cancer] screening in high-risk populations,” and “warrant future prospective investigation to better understand the relationship between IBD and [prostate cancer],” the study concluded.
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