Risk factors include older age and higher PSA density.

German researchers found that one in 10 men undergoing laser surgery for benign prostatic hyperplasia (BPH) also had prostate cancer (PCa).

Sascha A. Ahyai, MD, and colleagues at University Hospital Hamburg Eppendorf examined the rate of these incidental cancers among 238 men who underwent holmium laser enucleation of the prostate (HoLEP), which allows a complete pathologic assessment of retrieved tissue.

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Of the 238 patients, 24 (10%) had incidental PCa. Fourteen of the 24 (58%) patients had at least one negative result on a preoperative biopsy performed because they had a PSA level above 4 ng/mL. Six men (25%) had high grade cancer. In a subgroup of 121 (51%) HoLEP patients aged 70 years or younger, the rate of incidental PCa was significantly lower at 4.1% (five patients).

Patients with incidental PCa were significantly older than those without PCa (74.2 vs. 70 years) and had a significantly higher PSA density (0.17 vs. 0.07). The researchers presented their findings at the 24th Annual European Association of Urology Congress in Stockholm.

In a separate study presented at the conference, researchers at the Technical University of Dresden in Germany found an 11% rate of incidental PCa among 1,000 men undergoing transurethral resection of the prostate for BPH. Older age and higher BMI were significantly correlated with the presence of PCa, but preoperative PSA was not.