Prostate cancer risk higher in men with IBD, study confirms

Last Updated: 2018-12-28

By Anne Harding

NEW YORK (Reuters Health) - Men with inflammatory bowel disease (IBD) are four to five times as likely as their peers without IBD to develop clinically significant prostate cancer, according to a new study.

"We have to study this further, but since these patients with inflammatory bowel disease are getting frequent colonoscopies and frequent exams, it may be worthwhile to see that a good prostate exam is performed, but again, we do have to validate this in future studies," Dr. Shilajit D. Kundu of Northwestern University Feinberg School of Medicine in Chicago told Reuters Health by phone.

Epidemiological research has linked IBD to prostate cancer, but the association has not been studied in the prostate-specific antigen (PSA) era, Dr. Kundu noted.

Screening for prostate cancer with PSA testing is "controversial," he and his colleagues write in European Urology, online December 4.

The study team compared 1,033 male IBD patients who underwent prostate cancer screening at their medical center in 1996-2017 to 9,306 controls who did not have IBD.

Ten-year prostate cancer incidence was 4.4% for men with IBD compared to 0.65% among controls (hazard ratio, 4.84; P<0.001); for clinically significant prostate cancer, the incidence was 2.4% and 0.42%, respectively (HR, 4.04; P<0.001).

Men with IBD also had higher average PSAs than men without IBD starting at about age 55.

"Not only do men with inflammatory bowel disease have an increased risk of cancer, they have an increased risk of clinically significant cancer that would warrant treatment," Dr. Kundu said.

While doctors may assume that an elevated PSA in an IBD patient is related to the disease, he added, "if a man with inflammatory bowel disease who feels OK has an elevated PSA, we shouldn't necessarily assume that it's just coming from inflammation of his gut. It may be a sign that he should be checked for prostate cancer."

SOURCE: https://bit.ly/2SWCHXJ

Eur Urol 2018.