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The link between benign prostatic hyperplasia and prostate cancer

Abstract

Benign prostatic hyperplasia (BPH) and prostate cancer are among the most common diseases of the prostate gland and represent significant burdens for patients and health-care systems in many countries. The two diseases share traits such as hormone-dependent growth and response to antiandrogen therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH as a causal factor for prostate cancer development could improve the accuracy of prognostication and expedite intervention, potentially reducing the number of men who die from prostate cancer.

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Figure 1: Shared risk factors such as inflammation, metabolic factors, hormonal influences, and genetic variation predispose men to both benign prostatic hyperplasia (BPH) and prostate cancer (depicted by black arrows).

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Acknowledgements

This work was supported by Herlev Hospital, Copenhagen University Hospital, the Jascha Foundation, and the University of Copenhagen.

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D. D. Ørsted researched and wrote this article, as well as making significant contributions towards discussions of contents. S. E. Bojesen discussed content with D. D. Ørsted and reviewed the manuscript prior to publication.

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Correspondence to Stig E. Bojesen.

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Ørsted, D., Bojesen, S. The link between benign prostatic hyperplasia and prostate cancer. Nat Rev Urol 10, 49–54 (2013). https://doi.org/10.1038/nrurol.2012.192

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