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Cancer Epidemiol Biomarkers Prev. 2017 Oct;26(10):1549-1557. doi: 10.1158/1055-9965.EPI-17-0503. Epub 2017 Jul 28.

A Prospective Study of Chronic Inflammation in Benign Prostate Tissue and Risk of Prostate Cancer: Linked PCPT and SELECT Cohorts.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. eplatz1@jhu.edu ademarz@jhmi.edu.
2
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.
3
James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
4
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
5
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
6
Department of Oncology, Herbert Irving Comprehensive Cancer Center at Columbia University, New York, New York.
7
Department of Pathology, University of Colorado School of Medicine, Aurora, Colorado.
8
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
9
Moores Cancer Center, University of California San Diego, La Jolla, California.
10
Division of Cancer Prevention, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, Maryland.
11
Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio, Texas.
12
Christus Santa Rosa Health System and Christus Oncology Research Council, San Antonio, Texas.
13
SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
14
Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
15
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland. eplatz1@jhu.edu ademarz@jhmi.edu.

Abstract

Background: We leveraged two trials to test the hypothesis of an inflammation-prostate cancer link prospectively in men without indication for biopsy.Methods: Prostate Cancer Prevention Trial (PCPT) participants who had an end-of-study biopsy performed per protocol that was negative for cancer and who subsequently enrolled in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) were eligible. We selected all 100 cases and sampled 200 frequency-matched controls and used PCPT end-of-study biopsies as "baseline." Five men with PSA > 4 ng/mL at end-of-study biopsy were excluded. Tissue was located for 92 cases and 193 controls. We visually assessed inflammation in benign tissue. We estimated ORs and 95% confidence intervals (CI) using logistic regression adjusting for age and race.Results: Mean time between biopsy and diagnosis was 5.9 years. In men previously in the PCPT placebo arm, 78.1% of cases (N = 41) and 68.2% of controls (N = 85) had at least one baseline biopsy core (∼5 evaluated per man) with inflammation. The odds of prostate cancer (N = 41 cases) appeared to increase with increasing mean percentage of tissue area with inflammation, a trend that was statistically significant for Gleason sum <4+3 disease (N = 31 cases; vs. 0%, >0-<1.8% OR = 1.70, 1.8-<5.0% OR = 2.39, ≥5% OR = 3.31, Ptrend = 0.047). In men previously in the finasteride arm, prevalence of inflammation did not differ between cases (76.5%; N = 51) and controls (75.0%; N = 108).Conclusions: Benign tissue inflammation was positively associated with prostate cancer.Impact: This first prospective study of men without biopsy indication supports the hypothesis that inflammation influences prostate cancer development. Cancer Epidemiol Biomarkers Prev; 26(10); 1549-57. ©2017 AACR.

PMID:
28754796
PMCID:
PMC5626618
DOI:
10.1158/1055-9965.EPI-17-0503
[Indexed for MEDLINE]
Free PMC Article

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