Acute urinary retention and risk of cancer: population based Danish cohort study

Abstract

Objective To examine the risk of urogenital, colorectal, and neurological cancers after a first diagnosis of acute urinary retention. Design Nationwide population based cohort study. Setting All hospitals in Denmark. Participants 75 983 patients aged 50 years or older with a first hospital admission for acute urinary retention during 1995-2017. Main outcome measures Absolute risk of urogenital, colorectal, and neurological cancer and excess risk of these cancers among patients with acute urinary retention compared with the general population. Results The absolute risk of prostate cancer after a first diagnosis of acute urinary retention was 5.1% (n=3198) at three months, 6.7% (n=4233) at one year, and 8.5% (n=5217) at five years. Within three months of follow-up, 218 excess cases of prostate cancer per 1000 person years were detected. An additional 21 excess cases per 1000 person years were detected during three to less than 12 months of follow-up, but beyond 12 months the excess risk was negligible. Within three months of follow-up the excess risk for urinary tract cancer was 56 per 1000 person years, for genital cancer in women was 24 per 1000 person years, for colorectal cancer was 12 per 1000 person years, and for neurological cancer was 2 per 1000 person years. For most of the studied cancers, the excess risk was confined to within three months of follow-up, but the risk of prostate and urinary tract cancer remained increased during three to less than 12 months of follow-up. In women, an excess risk of invasive bladder cancer persisted for several years. Conclusions Acute urinary retention might be a clinical marker for occult urogenital, colorectal, and neurological cancers. Occult cancer should possibly be considered in patients aged 50 years or older presenting with acute urinary retention and no obvious underlying cause.

Acute urinary retention in men: 21‐year trends in incidence, subsequent benign prostatic hyperplasia‐related treatment and mortality: A Danish population‐based cohort study

“…Since we excluded patients with previous prostate cancer, previously diagnosed prostate cancer could not explain the excess risk of dying from malignancies. We previously examined the association between AUR and cancer in a Danish nationwide cohort study, and found AUR to be a marker of occult urogenital, colorectal, and neurological cancer 26 . While infections can directly cause AUR, AUR hospitalization is also associated with a potential risk of nosocomial and catheter‐related infections 18 .…”

“…We previously examined the association between AUR and cancer in a Danish nationwide cohort study, and found AUR to be a marker of occult urogenital, colorectal, and neurological cancer. 26 While infections can directly cause AUR, AUR hospitalization is also associated with a potential risk of nosocomial and catheter‐related infections. 18 Due to the design of our study, causation cannot be inferred.…”