Associations of benign prostatic hyperplasia with prostate cancer: the debate continues.

摘要

In the current issue of European Urology, Orsted and colleagues present a large cohort analysis investigating the association of benign prostatic hyperplasia (BPH) with prostate cancer (PCa) [1]. Utilizing data from five national registries, the authors examined the entire Danish male population from 1980 through 2006. They defined clinical BPH as hospitalization, surgery, or initiation of medical therapy (alpha-adrenergic receptor antagonists or 5alpha-reductase inhibitors [5-ARIs]) and calculated PCa incidence and mortality for each of these definitions. The analytic cohort contained more than 3 million men with a median age of 72 yr at diagnosis of PCa. Age-matched cohort studies were utilized to correct for influence of age and calendar year on PCa incidence. Men with clinical BPH were more likely to be diagnosed with PCa compared with those without clinical BPH: Adjusted hazards ratios for PCa incidence were 3.04 for BPH hospitalization, 2.60 for BPH surgery, 4.49 for a-adrenergic receptor antagonist use, and 2.54 for 5-ARI use. The authors concluded that clinical BPH was associated with a two-fold to three-fold increased risk of subsequent PCa diagnosis and that these men were two to eight times more likely to die from PCa.