Abstract
BackgroundWhether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk.MethodsFifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007–2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug registers. Associations were investigated using conditional logistic regression, including for disease/drug subtypes and exposure length/dose.ResultsMen with a history of any CID had slightly increased risk of any prostate cancer diagnosis (OR: 1.08; 95%CI: 1.04–1.12) but not ‘unfavourable’ (high-risk or advanced) prostate cancer. Generally, risk of prostate cancer was highest for shorter exposure times. However, a positive association was observed for asthma > 5 years before prostate cancer diagnosis (OR: 1.21; 95%CI: 1.05–1.40). Risk of prostate cancer was increased with prior use of any AIMs (OR: 1.26; 95%CI: 1.24–1.29). A positive trend with increasing cumulative dose was only observed for inhaled glucocorticoids (p < 0.011).ConclusionDetection bias most likely explains the elevated risk of prostate cancer with prior history of CIDs or use of AIMs, given the higher risk immediately after first CID event and lack of dose response. However, findings for length of time with asthma and dose of inhaled glucocorticoids suggest that asthma may increase risk of prostate cancer through other pathways.
Highlights
Whether chronic inflammation increases prostate cancer risk remains unclear
Previous evidence of positive associations between chronic inflammatory diseases (CID)/anti-inflammatory medication use (AIM) and prostate cancer may be affected by detection bias, resulting from frequent health service encounters or investigations leading to detection of prostate cancer, especially for men with localised inflammation arising from prostatitis or Sexually Transmitted disease (STD) [22]
Our a priori hypotheses were that risk of prostate cancer would be increased among men with CIDs due to persistent or recurring exposure to inflammatory mediators, while risk would be reduced among men who used AIMs, due to anti-inflammatory properties of these drugs
Summary
This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk. On the other hand, reduced risk of prostate cancer has been reported with exposure to some anti-inflammatory medications (AIMs) used to manage CIDs, though again the evidence is mixed [18,19,20,21]. The aim of this study was to investigate the link between chronic inflammation and risk of prostate cancer by examining the association between 1) history of CIDs, and 2) use of AIMs, and prostate cancer incidence, using population-wide registry-based data. Our a priori hypotheses were that risk of prostate cancer would be increased among men with CIDs due to persistent or recurring exposure to inflammatory mediators, while risk would be reduced among men who used AIMs, due to anti-inflammatory properties of these drugs
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