Obesity, diabetes, family history up risk of prostate cancer in IBD patients

A longitudinal national database study of patients with inflammatory bowel disease (IBD) has identified several risk factors for the development of prostate cancer (PC), including age, obesity, diabetes, married status, family history of PC, and African American race.

“Careful evaluation and follow-up is advised for IBD patients,” said the researchers, who presented their study at the virtual 2022 Crohn’s & Colitis Congress.

Lead author Ishaan Jakhar and colleagues sought to investigate the incidence, characteristics, and risk factors for PC in patients diagnosed with IBD using Center Health Facts, a national longitudinal database representing nearly 69 million patients.

The study included all male patients with IBD aged >40 years. Development of PC, as specified by the International Classification of Diseases coding, was the primary endpoint. The authors used multivariable regression built using all variables with p<0.1 on univariable analysis to assess patient characteristics as potential risk factors for PC development.

A total of 44,551 patients with IBD (mean age 59.7 years) were identified, of whom 992 (2.23 percent) developed PC. Additionally, 4,297 patients (9.65 percent) were obese, 36,929 (82.9 percent) were White, and 3,470 (7.8 percent) were African American. Of the patients, 41,829 (94.9 percent) received care at an acute care facility, and 37,266 (83.7 percent) received care at an urban facility.

Multivariate analysis revealed that diabetes (odds ratio [OR], 1.20, 95 percent confidence interval [CI], 1.03‒1.40), obesity (OR, 1.22, 95 percent CI, 1.00‒1.50), age (OR, 1.07, 95 percent CI, 1.06‒1.07), family history of PC (OR, 6.04, 95 percent CI, 4.02‒12.00), married status (OR, 1.43, 95 percent CI, 1.24‒1.65), and African American race (OR, 2.00, 95 percent CI, 1.61‒2.48) were significantly associated with a higher risk of PC. [Inflamm Bowel Dis 2022;28(Suppl 1):S21-S22]

In contrast, presentation at an acute facility (OR, 0.59, 95 percent CI, 0.46‒0.76) and other race (OR, 0.70, 95 percent CI, 0.53‒0.92) reduced the risk of developing PC. Additionally, the following factors did not correlate with high PC risk: smoking, sexually transmitted disease, alcohol use disorder, presentation at teaching facility, and facility size/type.

An earlier systematic review of 349 articles investigating the incidence of PC in IBD patients found two studies reporting an increase in PC risk among men with IBD and five studies reporting an elevated risk of PC in men with UC or with CD specifically. On the other hand, two studies reported a reduced PC risk among UC and IBD patients treated with aminosalicylates. [Arab J Urol 2020;18:207-212]

“Our findings confirm a complex interplay between IBD and PC, including factors such as genetic predisposition, systemic inflammation, and treatment effects,” the authors, led by Anoud Haddad from the University of Jordan, said. “The modulatory effect of treatment strategies for IBD on the development and progression of PC might be of clinical significance.”

PC is the second leading cause of cancer death among men in the US. [Inflamm Bowel Dis 2022;28(Suppl 1):S21-S22]