Boehm Katharina, Valdivieso Roger, Meskawi Malek, Larcher Alessandro, Sun Maxine, Sosa José, Blanc-Lapierre Audrey, Weiss Deborah, Graefen Markus, Saad Fred, Parent Marie-Élise, Karakiewicz Pierre I
Martini-Klinik am Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, 264 Blvd. Rene-Levesque E. Room 228, Montreal, QC, H2X 1P1, Canada.
World J Urol. 2015 Dec;33(12):2063-9. doi: 10.1007/s00345-015-1546-z. Epub 2015 Apr 1.
In a population-based case-control study (PROtEuS), we examined the association between prostate cancer (PCa) and (1) benign prostatic hypertrophy (BPH) history at any time prior to PCa diagnosis, (2) BPH-history reported at least 1 year prior to interview/diagnosis (index date) and (3) exposure to BPH-medications.
Cases were 1933 men with incident prostate cancer diagnosed across Montreal French hospitals between 2005 and 2009. Population controls were 1994 men from the same age distribution and residential area. In-person interviews collected socio-demographic characteristics and medical history, e.g., BPH diagnosis, duration and treatment, as well as on PCa screening. Logistic regression analyses tested overall and grade-specific associations, including subgroup analyses with frequent PSA testing.
A BPH-history was associated with an increased risk of PCa (OR 1.37 [95 % CI 1.16-2.61]), more pronounced for low-grade PCa (Gleason ≤6: OR 1.54 [1.26-1.87]; Gleason ≥7: OR 1.05 [0.86-1.27]). The association was not significant when BPH-history diagnosis was more than 1 year prior to index date, except for low-grade PCa (OR 1.29 [1.05-1.60]). Exposure to 5α reductase inhibitors (5α-RI) resulted in a decreased risk of overall PCa (OR 0.62 [0.42-0.92]), particularly for intermediate- to high-grade PCa (Gleason ≤6: OR 0.70 [0.43-1.14]; Gleason ≥7: OR 0.43 [0.26-0.72]). Adjusting for PSA testing frequency or restricting analyses to frequently screened subjects did not affect these results.
BPH-history was associated with an increased PCa risk, which disappeared, when BPH-history did not include BPH diagnosis within the previous year. Our results also suggest that 5α-RI exposure exerts a protective effect on intermediate and high-grade PCa.
在一项基于人群的病例对照研究（PROtEuS）中，我们研究了前列腺癌（PCa）与以下因素之间的关联：（1）前列腺癌诊断前任何时间的良性前列腺增生（BPH）病史；（2）在访谈/诊断（索引日期）前至少1年报告的BPH病史；以及（3）BPH药物暴露情况。
病例为2005年至2009年间在蒙特利尔法语医院确诊的1933例新发前列腺癌男性患者。人群对照为1994名来自相同年龄分布和居住地区的男性。通过面对面访谈收集社会人口学特征和病史，如BPH诊断、病程和治疗情况，以及前列腺癌筛查情况。采用逻辑回归分析检验总体和分级特异性关联，包括频繁进行PSA检测的亚组分析。
BPH病史与PCa风险增加相关（OR 1.37 [95% CI 1.16 - 2.61]），在低级别PCa中更为明显（Gleason评分≤6：OR 1.54 [1.26 - 1.87]；Gleason评分≥7：OR 1.05 [0.86 - 1.27]）。当BPH病史诊断在索引日期前超过1年时，该关联不显著，但低级别PCa除外（OR 1.29 [1.05 - 1.60]）。暴露于5α还原酶抑制剂（5α-RI）会导致总体PCa风险降低（OR 0.62 [0.42 - 0.92]），尤其是中高级别PCa（Gleason评分≤6：OR 0.70 [0.43 - 1.14]；Gleason评分≥7：OR 0.43 [0.26 - 0.72]）。调整PSA检测频率或仅对频繁筛查的受试者进行分析并不影响这些结果。
BPH病史与PCa风险增加相关，当BPH病史不包括前一年的BPH诊断时，这种关联消失。我们的结果还表明，5α-RI暴露对中高级别PCa具有保护作用。
