Prostate cancer patients may have an increased risk of coexisting advanced colorectal neoplasms.
OBJECTIVE
Patients being treated for prostate cancer (PCa) have an increased risk of developing colorectal cancer. However, whether PCa patients are inherently at a higher risk of colorectal neoplasms (CRNs) is unknown. We aimed to investigate the risk of CRNs in PCa patients.


METHODS
Patients who had been diagnosed with PCa at a tertiary medical center and had colonoscopy within 1 year of the PCa diagnosis were investigated. Patients were propensity-matched 1:2 by age and body mass index to asymptomatic control subjects who had undergone colonoscopy for routine health screening. CRN was defined as histological confirmation of an adenoma or adenocarcinoma component. Advanced CRN was defined as any of the following: 1) histological findings of high-grade dysplasia, 2) inclusion of villous features, 3) tumor ≥1 cm in size, or 4) presence of an adenocarcinoma. Risk factors for CRN and advanced CRN were evaluated by univariate and multivariate analysis.


RESULTS
A total of 191 patients diagnosed with PCa had colonoscopies within 1 year of PCa diagnosis. Of these, 23 patients with a history of previous malignancy and seven with incomplete colonoscopies were excluded, leaving 161 patients in the PCa group. Although presence of PCa was not a significant risk factor for CRN by multivariate analysis, PCa was a significant risk factor for advanced CRN (odds ratio [OR] 3.300; 95% confidence interval [CI] 1.766-6.167; P<0.001). Other significant risk factors for advanced CRN were age (OR 1.050; 95% CI 1.003-1.009; P=0.036) and body mass index (OR 1.205; 95% CI 1.067-1.361; P=0.003), whereas aspirin use (OR 0.414; 95% CI 0.173-0.990; P=0.047) was a preventive factor.


CONCLUSIONS
The risk of advanced CRN may be significantly increased in patients with PCa. Patients with PCa should have a colonoscopy at the time of PCa diagnosis.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Sun-Hye
SH
Ko
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Internal Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, South Korea.
Myong Ki
MK
Baeg
Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Woong Jin
WJ
Bae
Department of Internal Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, South Korea.
Pumsoo
P
Kim
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Myung-Gyu
MG
Choi
colonoscopy; colorectal adenoma and carcinoma; colorectal neoplasms; prostate cancer
Cancer. 2012 Dec 15;118(24):6207-16
22674346
Eur Urol. 2007 Aug;52(2):331-43
17507151
Gastroenterology. 2012 Sep;143(3):844-57
22763141
Int J Cancer. 2011 Apr 1;128(7):1659-67
20503267
Urology. 2003 Nov;62(5 Suppl 1):27-33
14607215
Oncogene. 2006 Dec 4;25(57):7531-7
17143297
Gastroenterology. 2007 May;132(6):2208-25
17498513
ANZ J Surg. 2003 May;73(5):289-93
12752284
N Engl J Med. 2004 May 27;350(22):2239-46
15163773
Lancet Oncol. 2014 Oct;15(11):e484-92
25281467
Gastrointest Endosc. 1997 Dec;46(6):497-502
9434215
Cancer Causes Control. 2014 Feb;25(2):237-49
24265089
BJU Int. 2012 Dec;110(11):1696-701
22889401
Ann Surg Oncol. 2013 May;20(5):1614-22
23361895
Clin Cancer Res. 2004 May 1;10(9):2918-21
15131025
Colorectal Dis. 2014 Nov;16(11):888-95
25039837
Gastroenterology. 2014 Aug;147(2):502-26
25043945
Int J Oncol. 2013 Oct;43(4):973-84
23900573
Cancer. 2006 Sep 1;107(5):991-8
16878323
J Clin Oncol. 2013 May 10;31(14):1713-8
23530095
Int J Colorectal Dis. 2015 Mar;30(3):353-61
25518811
Dig Dis. 2011;29(2):222-8
21734388
Br J Cancer. 2008 Mar 11;98(5):997-1000
18283306
Radiother Oncol. 2002 Dec;65(3):145-51
12464442
Am J Epidemiol. 2009 Nov 1;170(9):1165-77
19808637
Cancer Epidemiol Biomarkers Prev. 2014 Aug;23(8):1447-9
25085835
J Natl Cancer Inst. 2010 Dec 1;102(23):1760-70
21068432
J Natl Cancer Inst. 2005 Jul 6;97(13):975-80
15998950
CA Cancer J Clin. 2014 Jul-Aug;64(4):252-71
24890451
Int J Gastrointest Cancer. 2003;34(1):49-54
15235135
Cancer Lett. 2006 Jun 8;237(1):22-32
16023783
Int J Cancer. 2010 Dec 15;127(12):2893-917
21351269
CA Cancer J Clin. 2014 Jul-Aug;64(4):225-49
24916760
Cancer. 2014 Dec 1;120 Suppl 23:3758-70
25412388
PLoS One. 2014 Jul 21;9(7):e102596
25047238
Pract Radiat Oncol. 2012 Jul-Sep;2(3):e7-e13
24674130
J Clin Oncol. 2011 Oct 1;29(28):3775-82
21876081
Cancer Epidemiol. 2014 Feb;38(1):42-7
24275259
Cancer. 2012 Dec 1;118(23):5955-63
22605665
Eur J Cancer. 2010 Sep;46(14):2593-604
20843488
N Engl J Med. 2014 Aug 28;371(9):799-807
25162886
Anticancer Res. 2000 Jan-Feb;20(1B):559-61
10769725
Gut. 2010 Dec;59(12):1670-9
20844293