Impact of Benign Prostatic Hyperplasia and/or Prostatitis on the Risk of Prostate Cancer in Korean Patients

Abstract

Prostate cancer (PCa) is the second most common cancer and the fifth leading cause of cancer-related death worldwide [1]. In Korea, the incidence of PCa is increasing rapidly [2]. Currently, there are established risk factors for diagnosing PCa [3]. Family history, increased age, and ethnicity are established risk factors for PCa diagnosis, while among many other potential risk factors, benign prostatic hyperplasia (BPH) andPurpose: We evaluated the impact of benign prostatic hyperplasia (BPH) and prostatitis on the risk of prostate cancer (PCa) in patients using nationally representative data of the Korean population from the National Health Insurance Service. Materials and Methods: A total of 5,580,495 Korean men, aged >20 years, who had undergone health screening in 2009 were followed-up for 9 years until 2017. Multivariate adjusted Cox regression analysis was conducted to determine the hazard ratio (HR) and 95% confidence interval (CI) for the association between BPH and/or prostatitis and PCa. The HR for PCa according to the presence of BPH and/or prostatitis was stratified by a combination of BPH and prostatitis in multivariableadjusted models. Results: The HR for PCa significantly increased in patients with BPH and prostatitis than in patients without BPH and prostatitis (adjusted HR, 1.626; 95% CI, 1.567-1.688 and adjusted HR, 1.557; 95% CI, 1.500-1.618, respectively). In particular, for the combination of BPH and prostatitis, the adjusted HR was 1.856 (95% CI, 1.743-1.976), which was the highest when a diagnosis of both BPH and prostatitis was made. Conclusions: BPH and/or prostatitis are associated with an increased incidence for PCa in Korean patients, which is likely associated with similar effects to prostate-specific antigen (PSA) screening, so care must be taken in the interpretation. However, if follow-up survival studies demonstrate differences between the two groups (BPH and prostatitis vs. general), it could be one of the evidence for the introduction of PSA screening in Korea.

Delaying a Biopsy With Serial Prostate-Specific Antigen Checkup Helps to Identify a Significant Prostate Cancer: A Strategy to Evade Unnecessary Procedures

“…There are several series that traced the clinical implication of PSA decrease following BPH/ LUTS medication, including alpha-blockers and antibiotics. Tubaro et al 12 A decrease in PSA in suspicious levels was also reported in studies that administered antibiotics 14,15 because subclinical inflammation of the prostate could elevate serum PSA in an asymptomatic way.…”

Inflammation induced by lipopolysaccharide advanced androgen receptor expression and epithelial-mesenchymal transition progress in prostatitis and prostate cancer

“…Kim SH reported the incidence of PCa in prostatitis was 1.64%. Furthermore, the patients with prostatitis had a higher risk of PCa than the patients without prostatitis (12). Chronic asymptomatic prostatitis was detected in 31% patients with PCa, and there was a positive correlation between the inflammation aggressiveness grade and urological pathology grades.…”

Effect of continuity nursing based on the theory of Knowledge-Attitude-Practice on quality of life, self-efficacy, and treatment compliance in elderly patients with benign prostatic hyperplasia

“…The chronic nature of the disease can lead to feelings of tension, anxiety, and depression, affecting both the quality of life and disease recovery for patients. [ 3 , 4 ] Although complete cure for BPH is currently unachievable, clinical treatment options exist that significantly improve symptoms in affected individuals. Additionally, providing appropriate nursing measures and health guidance during the treatment process have positive implications for alleviating patient conditions and improving quality of life.…”