Diagnosis of BPH not a risk factor for prostate cancer

A re-analysis of data from patients enrolled in the Prostate Cancer Prevention Trial (PCPT) has now provided “the strongest evidence to date” that a diagnosis of symptomatic benign prostatic hyperplasia (BPH) is not associated with any increase in risk for prostate cancer.

This study, just published on line by Schenk et al. in the American Journal of Epidemiology, was designed to investigate the possibility of any association between symptomatic BPH and prostate cancer risk. The study cohort was made up of 5,068 participants in the PCPT, all enrolled between 1993 and 2003 and randomized to the placebo arm of the trial.

A total of 1,225/5,068 men in this study cohort (24.2 percent) were found to have prostate cancer during the 7-year-long trial. The other  3,843 men were shown to be prostate cancer-free as a result of a prostate biopsy that was negative for prostate cancer at the trial’s conclusion. The occurrence of symptomatic BPH was assessed among the study cohort based on one or more of the following:

  • Self-reporting of surgical or medical treatment for BPH
  • The presence of  moderately severe symptoms of BPH (International Prostate Symptom Score >14)
  • Physician diagnosis

Data analyses were based on BPH status at baseline (prevalent) or the presence of BPH prior to cancer diagnosis or study end (prevalent + incident).

After data were controlled for age, race, and body mass index:

  • There was no association between the presence of  prevalent, symptomatic BPH and risk for prostate cancer (risk ratio [RR]  = 1.03).
  • There was no association between the presence of prevalent + incident , symptomatic BPH and risk for prostate cancer (RR = 0.96).
  • The lack of evidence for any association was consistent across subgroups defined by
    • Type of BPH-defining event (treatment, symptoms, or physician diagnosis)
    • Prompt for prostate cancer diagnosis, and
    • Prostate cancer grade

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