Prostate carcinoma risk subsequent to diagnosis of benign prostatic hyperplasia: a population-based cohort study in Sweden.
BACKGROUND
Pathologically, benign prostatic hyperplasia (BPH) is not considered a precursor for prostate carcinoma. However, because the two conditions share not only a similar hormonal environment within the prostate but also several common risk factors, it is possible that men with BPH may be at increased risk of prostate carcinoma due to these shared factors.


METHODS
To elucidate this further, the authors used Swedish nationwide population-based record-linkage data to assess prostate carcinoma risk up to 26 years after the diagnosis of BPH among 86,626 men.


RESULTS
Overall, relative to the general population, patients with BPH experienced little, if any, excess risk of prostate carcinoma (2% excess incidence after 10 years of follow-up). However, patients with BPH with and without surgical intervention experienced different prostate carcinoma risk patterns. Those undergoing transvesicular adenomectomy had a significant 22% lower incidence and a 23% lower mortality after the first 5 years of follow-up and those undergoing transurethral resection had a significant 10% higher incidence but a 17% lower mortality. In contrast, after the first 5 years, patients with BPH who did not receive surgical intervention experienced significant excesses of both prostate carcinoma incidence (18%) and mortality (77%).


CONCLUSIONS
The differences in prostate carcinoma incidence and mortality by BPH treatment type suggest that factors related to treatment or health reasons underlying the selection of treatment influence subsequent prostate carcinoma risk. Further studies are needed to confirm the minimal excess risk of prostate carcinoma among BPH patients overall and the possible impact of BPH treatment methods on subsequent prostate carcinoma risk.
Chokkalingam
Anand P
AP
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20892, USA.
Nyrén
Olof
O
Johansson
Jan-Erik
JE
Gridley
Gloria
G
McLaughlin
Joseph K
JK
Adami
Hans-Olov
HO
Hsing
Ann W
AW
D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000601:surgery; D011471:Prostatic Neoplasms / Q000209:etiology*; D012307:Risk Factors; D013548:Sweden; D020728:Transurethral Resection of Prostate