Previously described associations between lower urinary tract symptoms (LUTS) and prostate cancer (PCa) may not be due to an underlying shared biologic etiology or causative mechanism, but rather increased diagnostic intensity among men whose LUTS comes to the attention of physicians, researchers reported online in European Urology.

Christopher J. Weight, MD, of Mayo Clinic in Rochester, Minn., and colleagues followed a representative population-based cohort of 1,922 men aged 40-79 years from 1990 until 2010 with interviews, questionnaires, and abstracting of medical records for prostate outcomes. The researchers identified 168 men treated for LUTS. The median follow-up was 11.8 years.

Of the eligible men, 55% enrolled in the study. Men treated for LUTS were 2.4 times more likely than those not treated for LUTS to undergo a prostate biopsy. Men younger than 65 years who were treated for LUTS were 2.3 times more likely to be diagnosed with PCa, whereas those older than 65 were not. Men with self-reported LUTS were not more likely to undergo biopsy or be diagnosed with PCa.

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The authors acknowledged that their study was limited by a lack of histologic or PSA data for the cohort.