Association of Symptomatic Benign Prostatic Hyperplasia and Prostate Cancer: Results from the Prostate Cancer Prevention Trial
Association of Symptomatic Benign Prostatic Hyperplasia and Prostate Cancer: Results from the Prostate Cancer Prevention Trial
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DOI：
10.1093/aje/kwq493
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发表时间：
2011-06-15
影响因子：
5
通讯作者：
Thompson, Ian M.
中科院分区：
文献类型：
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作者：
Schenk, Jeannette M.;Kristal, Alan R.;Thompson, Ian M.
这项研究调查了参加前列腺癌预防试验（1993-2003）的 5,068 名安慰剂组参与者的症状性良性前列腺增生 (BPH) 与前列腺癌风险之间的关联。这些数据包括 1,225 名在为期 7 年的试验期间被检测出癌症的男性，其中 556 名男性因前列腺特异性抗原异常或直肠指检后被检测出患有癌症，669 名男性因非原因被检测出（无指征），以及 3,843 名在试验结束时经活检证明不存在前列腺癌的男性。有症状的 BPH 按手术或药物治疗的自我报告、中度严重症状（国际前列腺症状评分 > 14）或医生诊断进行分层评估，并根据基线时的 BPH 状态（流行）或癌症诊断或研究结束前的 BPH 状态（流行加事件）完成分析。控制年龄、种族和体重指数后，无论是患病率（风险比 = 1.03，95% 置信区间：0.92, 1.14）还是患病率加事件（风险比 = 0.96，95% 置信区间：0.87, 1.06），症状性 BPH 均与前列腺癌风险无关。这种关联的缺乏在由 BPH 定义事件类型（治疗、症状或医生诊断）、前列腺癌诊断提示和前列腺癌分级定义的亚组中是一致的。这项研究提供了迄今为止最有力的证据，证明 BPH 不会增加前列腺癌的风险。
This study examined the association between symptomatic benign prostatic hyperplasia (BPH) and prostate cancer risk in 5,068 placebo-arm participants enrolled in the Prostate Cancer Prevention Trial (1993-2003). These data include 1,225 men whose cancer was detected during the 7-year trial-556 detected for cause (following abnormal prostate-specific antigen or digital rectal examination) and 669 detected not for cause (without indication), as well as 3,843 men who had biopsy-proven absence of prostate cancer at the trial end. Symptomatic BPH was assessed hierarchically as self-report of surgical or medical treatment, moderately severe symptoms (International Prostate Symptom Score > 14), or physician diagnosis, and analyses were completed by BPH status at baseline (prevalent) or BPH prior to cancer diagnosis or study end (prevalent plus incident). Controlled for age, race, and body mass index, neither prevalent (risk ratio = 1.03, 95% confidence interval: 0.92, 1.14) nor prevalent plus incident (risk ratio = 0.96, 95% confidence interval: 0.87, 1.06) symptomatic BPH was associated with prostate cancer risk. This lack of 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. This study provides the strongest evidence to date that BPH does not increase the risk of prostate cancer.