Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Eur Urol. 2019 May;75(5):846-852. doi: 10.1016/j.eururo.2018.11.039. Epub 2018 Dec 4.
There are limited data examining the risk of prostate cancer (PCa) in patients with inflammatory bowel disease (IBD).
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.
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.
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.
Men with IBD had higher rates of clinically significant PCa when compared with age- and race-matched controls.
This study of over 10000 men treated at a large medical center suggests that men with inflammatory bowel disease may be at a higher risk of prostate cancer than the general population.
目前关于炎症性肠病（IBD）患者罹患前列腺癌（PCa）的风险的数据有限。
比较 IBD 患者和非 IBD 患者 PCa 的发病率。
设计、地点和参与者：这是一项回顾性、匹配队列研究，涉及一家学术医疗中心，研究时间为 1996 年至 2017 年。IBD 男性患者（病例组=1033 例）按年龄和种族与非 IBD 男性患者（对照组=9306 例）进行 1:9 随机匹配。所有患者均至少接受过一次前列腺特异性抗原（PSA）筛查检测。
Kaplan-Meier 和多变量 Cox 比例风险模型，按年龄和种族分层，评估 IBD 与任何 PCa 和临床显著 PCa（Gleason 分级组≥2）的发病率之间的关系。混合效应回归模型评估 IBD 与 PSA 水平的相关性。
IBD 组男性患者的 10 年 PCa 发病率为 4.4%，对照组为 0.65%（风险比[HR]4.84[3.34-7.02] [3.19-6.69]，p<0.001）。IBD 组男性患者的 10 年临床显著 PCa 发病率为 2.4%，对照组为 0.42%（HR 4.04[2.52-6.48]，p<0.001）。大约 60 岁以后，IBD 患者的 PSA 值更高（年龄和患者组的固定效应交互作用：p=0.004）。结果受到分析的回顾性和缺乏外部有效性的限制。
与年龄和种族匹配的对照组相比，IBD 男性患者的临床显著 PCa 发生率更高。
这项在一家大型医疗中心接受治疗的 10000 多名男性患者的研究表明，炎症性肠病患者罹患前列腺癌的风险可能高于一般人群。
