Researchers sought to find new evidence regarding the role of inflammation in prostate cancer in this study led by Daniel Moreira, MD, of the North Shore-Long Island Jewish Health System in New Hyde Park, NY.
Dr. Moreira’s team analyzed data on 6,238 men between the ages of 50 and 75 who participated in the The REduction by DUtasteride of PCa Events (REDUCE) trial.
These gentlemen, who had a negative biopsy that indicated no cancer, had prostate-specific antigen (PSA) levels ranging from 2.5 to 10ng/mL. Participants had additional biopsies two and four years later.
In the initial (baseline) biopsies, acute (short-term) inflammation was seen in 15 percent of the men, chronic (long-term) inflammation was detected in 77 percent of participants, while both acute and chronic inflammation were present in 14 percent of the study members.
Acute inflammation tended to be seen in younger men with lower PSA levels and smaller prostates, while chronic inflammation was detected more often in older men with larger prostate glands.
Biopsies performed two years later showed a 28 percent reduced risk of prostate cancer in men with acute inflammation, and chronic inflammation lowered prostate cancer risk by 35 percent.
In the four-year biopsies, chronic inflammation didn’t impact cancer risks, but acute inflammation was associated with a 26 percent reduced risk.
The exact reasons for these associations remain unclear. However, the authors suggested that inflammation may have been the reason behind an elevated PSA level, which triggered the biopsy referral. They also theorized that the inflammation could have been caused by the immune system fighting off early cancer cells to prevent tumor formation.
Dr. Moreira said in a statement, “Given its predictive value, inflammation — and its type and severity — should be routinely reported in prostate biopsies. Also, it is possible that patients with inflammation at baseline biopsy may be followed differently compared with patients without inflammation at baseline biopsy given their risk of subsequent cancer detection is lower.”
"There are over 1.2 million prostate biopsies performed in the US per year, and only about 25 percent are positive for cancer, E. David Crawford, MD, professor of surgery, urology and radiation oncology, and head of the Section of Urologic Oncology at the University of Colorado Health, told daiyRx News. "Unfortunately, contained within those negative biopsies are about 25 percent of men who have a missed cancer. The importance of this study is that it eliminates some of the concern for presence of prostate cancer and should be used with clinical judgement and other markers such as Confirm MDX, an epigenetic test, to determine who needs another biopsy."
This study was published December 9 in CANCER, the peer-reviewed journal of the American Cancer Society.
Several of the authors reported financial ties with pharmaceutical companies and other commercial enterprises.