Clinical chronic prostatitis is associated with a significantly decreased risk of prostate cancer (PCa) in African American men, according to a new study.

Among white men, clinical prostatitis significantly increased PCa risk in those without histologic evidence of prostatic inflammation.

Benjamin A. Rybicki, PhD, of the Henry Ford Health System in Detroit, and collaborators analyzed data from 574 PCa case-control pairs (345 White, 229 African American). In adjusted analyses, African American men with clinical chronic prostatitis had a significant 53% decreased risk of PCa compared with African American men without prostatitis, the researchers reported online ahead of print in Prostate Cancer and Prostatic Diseases

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Clinical prostatitis did not significantly increase PCa risk in white men overall, but it was associated with a significant 3.5-fold increased risk in those who had no evidence of histologic prostatic inflammation. In addition, the investigators found that clinical prostatitis increased PCa risk nearly 3-fold in white men with a low PSA velocity and nearly 2-fold in white men with more frequent PSA testing. PSA level and PSA density did not significantly modify the effect of clinical prostatitis on PCa risk in African American men.

“Prostatitis is a biologically and clinically heterogeneous condition; as a result, determining its role in prostate carcinogenesis is challenging,” the authors wrote. “As clinically-reported prostatitis is more likely when the underlying prostatic inflammation is extensive, the factors that influence the spread of prostatic inflammation, and how these factors may promote carcinogenesis need to be better understood.”