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Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study
Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm SE-171 77, Sweden
Department of Medical Biosciences, Pathology, Umeå University, SE-901 87 Umeå, Sweden
* Author to whom correspondence should be addressed.
Received: 14 September 2011; in revised form: 24 October 2011 / Accepted: 28 October 2011 / Published: 8 November 2011
Abstract: Epidemiological and experimental evidence suggests that inflammation plays a role in both prostate cancer (PCa) and benign prostate hyperplasia (BPH). This study evaluates the risk of PC after transurethral resection (TURP) for BPH and estimates the PCa risk related to presence of inflammation in the resected material. The Pathology Department at the University Hospital of Umeå (Umeå, Sweden) identified BPH cases (n = 7,901) that underwent TURP between 1982 and 1997. Using these pathological specimens, we compared the incidence of PCa in the cohort to the population and calculated the standardized incidence and mortality ratios (SIR and SMR). Inflammation, the androgen receptor (AR), and p53 were evaluated in a nested case-control study of 201 cases and controls. Inflammation was graded severe or mild-moderate. In the follow-up period after TURP, cases developed prostate cancer and the controls did not. After TURP, SIR for prostate cancer increased [1.26, CI 95% (1.17–1.35)], whereas SMR decreased [0.59, CI 95% (0.47–0.73)]. Presence of inflammation at the time of TURP did not differ between cases and controls nor were there differences in p53 or AR staining. The data suggest a small increased risk of PCa after TURP and decreased PCa mortality. Inflammation at the time of TURP is not associated with PCa risk in this material. The increased PCa risk may be attributed to increased surveillance and PSA screening.
Keywords: prostate cancer; inflammation; benign prostate hyperplasia; androgen receptor; p53
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Karlsson, C.T.; Wiklund, F.; Grönberg, H.; Bergh, A.; Melin, B. Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study. Cancers 2011, 3, 4127-4138.
Karlsson CT, Wiklund F, Grönberg H, Bergh A, Melin B. Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study. Cancers. 2011; 3(4):4127-4138.
Karlsson, Camilla T.; Wiklund, Fredrik; Grönberg, Henrik; Bergh, Anders; Melin, Beatrice. 2011. "Risk of Prostate Cancer after Trans Urethral Resection of BPH: A Cohort and Nested Case-Control Study." Cancers 3, no. 4: 4127-4138.