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Quantifying risk of prostate cancer in men with inflammatory bowel disease.

Principal Investigator
Name
Shilajit Kundu
Degrees
MD
Institution
Northwestern University Feinberg School of Medicine
Position Title
Associate Professor of Urology
Email
About this CDAS Project
Study
PLCO (Learn more about this study)
Project ID
PLCO-428
Initial CDAS Request Approval
Dec 11, 2018
Title
Quantifying risk of prostate cancer in men with inflammatory bowel disease.
Summary
Previous epidemiologic studies have noted an association between chronic inflammation and prostate cancer. The risk of prostate cancer in men with chronic inflammatory conditions, specifically inflammatory bowel disease, is not well elucidated. Inflammatory bowel disease (IBD) affects 1.6 million adults in the United States. IBD is comprised of Crohn’s disease (CD) and ulcerative colitis (UC). Patients with IBD have an increased risk of gastrointestinal malignancy as well as extra-intestinal malignancies, including lymphoma and skin cancer. Key drivers of malignant transformation may include longstanding inflammation.
We recently published an article (European Urology; December 4, 2018) that has shown an association between IBD and prostate cancer. In this matched-cohort conducted from 1996 to 2017, male patients with IBD (cases = 1033) were randomly matched 1:9 by age and race to men without IBD (controls = 9306). All patients had undergone at least one prostate-specific antigen (PSA) screening test. PCa incidence at 10 yr was 4.4% among men with IBD and 0.65% among controls (hazard ratio [HR] 4.84 [3.34–7.02] [3.19–6.69], p < 0.001). Clinically significant PCa incidence at 10 yr was 2.4% for men with IBD and 0.42% for controls (HR 4.04 [2.52–6.48], p < 0.001). After approximately age 60, PSA values were higher among patients with IBD (fixed-effect interaction of age and patient group: p = 0.004.
Aims

The purpose of this study is to examine PLCO to validate the results of our previous study and to assess risk of prostate cancer based on baseline status of inflammatory bowel disease. Our preliminary queries have identified approximately 129 men with Crohn’s disease with and 707men with ulcerative colitis as reported on the BQ. We would like to examine rates of prostate cancer between men with IBD vs without IBD. PSA values and abnormal rectal exams will be examined in the screened cohort. The control cohort will be men without a self-reported history of IBD. We would also like to compare the rates of prostate cancer in other acute inflammatory conditions of the bowel, such as diverticulitis to serve as a secondary control to assess whether IBD, which is a chronic inflammatory condition, is associated with a greater risk of prostate cancer compared to men with more acute inflammation.
This data will be used as a validation of our previous reports and may help to delineate a group of men who may need to be considered for more rigorous prostate cancer screening.

Collaborators

Adam Weiner, Jacob Burns, Mark Antkowiak