Prostatic Inflammation May Lower Risk of PCa Detection

NIAGARA FALLS, Ont.—Acute or chronic prostatic inflammation each is independently associated with a significantly reduced risk of a prostate cancer (PCa) diagnosis, researchers reported at the Canadian Urological Association 2013 annual meeting. The presence of inflammation in a PCa-negative biopsy may lower the risk of PCa on repeat biopsy.

J. Curtis Nickel, MD, Professor of Urology at Queen's University in Kingston, Ont., and colleagues retrospectively analyzed data from 6,269 men who were in the REDUCE trial and who had a negative baseline cancer biopsy. They found a 25% lower risk of PCa within two years among men with acute inflammation found in the initial biopsy specimens and a 35% reduction in risk when chronic inflammation was present. The magnitude of the risk reduction was such that this information may be taken into consideration when planning further biopsies, Dr. Nickel said.

REDUCE is shorthand for the Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study of the Efficacy and Safety of Dutasteride 0.5 mg Administered Orally Once Daily for Four Years to Reduce the Risk of Biopsy-Detectable Prostate Cancer.

The subjects were 50 to 75 years old at baseline and had PSA levels of 2.5-10 ng/mL. Dr. Nickel and his co-authors found that men who had acute inflammation in the baseline biopsy were significantly younger, had lower PSA levels, and had smaller prostates than men without acute inflammation. Those with chronic inflammation were older and had larger prostates than men without chronic inflammation.

Cautioning against over-interpretation of the results, Dr. Nickel noted, “In this study, we didn't have access to previous biopsies in the subjects, including those who had prostate cancer on biopsies prior to screening, so our study couldn't tell us what the influence of earlier inflammation, if it was present, would have been.”

“The study gives us useful information because it helps us interpret what the pathologists tell us,” said Vincent Fradet, MD, PhD, a urologist at Laval University in Quebec City who was not involved in the study.

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