Risk of prostate cancer associated with benign prostate disease: A primary care case-control study

Abstract

Background: Benign diseases of the prostate are common in the generalmale population, and prostate cancer is themost common cancer inmen. Uncertainty as to the nature of the association between benign andmalignant disease is a source of concern for patients and clinicians. Aim: To determine the likelihood ofmen with benign prostate disease developing prostate cancer compared withmen without disease. Design: Incidentmatched case-control study Method: All incident cases of prostate cancer (n = 984) were identified in a nationally representative community-based population, and each was matched by age with two controls with no prostate cancer (n = 1968). Participants' records of the previous 5 years were searched for diagnoses of benign prostate disease. Analyses investigated an a priori hypothesis that cliniciansmay record disease as benign until proven to bemalignant, causingmisleading significant associations between benign and malignant diagnoses. Results: There was a significant association between a diagnosis of prostate cancer and a benign diagnosis at any time in the previous 5 years: odds ratio (OR) 1.57 (95% confidence interval [CI] = 1.32 to 1.88). However, there was no significant association when benign diagnoses within 6months and within 12months of cancer diagnoses were excluded: OR 1.19 (95% CI = 0.97 to 1.46) and OR 1.00 (95% CI = 0.79 to 1.27) respectively. Conclusion: Findings fromthis study suggest that unless prostate cancer is detected within 6months, men diagnosed for the first time with benign disease are at no greater risk of prostate cancer than those with no recorded prostate disease. ©British Journal of General Practice.