Men With IBD: Are They at Higher Risk of Prostate Cancer?

Men with inflammatory bowel disease (IBD) are more likely to develop prostate cancer than compared with the general population, according to a new study. This includes both low risk and clinically significant cancer that warrants treatment.

“Men with IBD are not recognized as a higher risk group,” Dr Kundu, chief of urologic oncology in the department of urology at Northwestern Medicine, told Gastroenterology Consultant. “Perhaps they should be considered for more careful screening.” 

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Currently, there is no standard practice for how to treat prostate-specific antigen (PSA) or categorize prostate cancer risk among men with IBD.

“We were seeing many men [with IBD] with elevations in PSA…We sought to study them for this reason,” Dr Kundu said. 

Kundu and colleagues reviewed data from 1996 to 2017 of 10,339 men who visited a single academic medical center. In all, 1033 had IBD and 9306 did not. Those without IBD—who acted as the controls—were matched by age and race to men with IBD.

All participants had undergone at least 1 prostate-specific antigen screening test.

At 10 years, the incidence of prostate cancer was 4.4% among men with IBD and 0.65% among men without IBD. Further, clinically significant prostate cancer, which warrants treatment, was 2.4% for men with IBD and 0.42% among men without IBD.

PSA was found to be higher among men with IBD after aged 60 years.

While a retrospective design and lack of external validity created limitations in the results, the researchers noted that men with IBD with high PSA should consider prostate cancer screening, and perhaps should be screened more carefully than the general population.

“Gastroenterologists should consider routine prostate exams in their patients with IBD,” Dr Kundu said. “Abnormalities in prostate exams should be referred to a urologist.” 

—Colleen Murphy

Reference:

Burns JA, Weiner AB, Catalona WJ, et al. Inflammatory bowel disease and the risk of prostate cancer [published online December 7, 2018]. Eur Urol. https://doi.org/10.1016/j.eururo.2018.11.039.