Patients with inflammatory bowel disease (IBD) are at increased risk of gastrointestinal and extraintestinal malignancies. However, the associations between IBD and prostate cancer (PCa) risk remain conflicting.
We conducted a systematic literature search in PubMed, EMBASE, and Web of Science databases. According to the inclusion and exclusion criteria, a total of nine studies were included in the meta-analysis. The pooled standardized incidence ratios (SIRs) or relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated to determine the relationship of IBD and PCa risk.
For cohort studies, the pooled SIR was 1.33 (95% CI = 1.03–1.71). The further subgroup analysis showed that the PCa risk was higher in patients with ulcerative colitis (UC) (pooled SIR = 1.58, 95% CI = 1.08–2.30), but not in patients with Crohn’s disease (CD) (pooled SIR = 1.12, 95% CI = 0.97–1.31). Besides, for the three case-control studies, the results indicated that compared with normal group, the pooled RR of PCa was 1.81 for the patients with IBD (95% CI = 1.43–2.29). In addition, sensitivity analysis indicated that the results were robust and no significant publication bias were observed.
Our findings based on the large and multicenter samples strongly indicated that men with IBD especial UC have significantly elevated PCa risk. Future efforts are needed to define the mechanism underlying the link between IBD and PCa or clinically significant PCa risk.
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Kappelman MD, Rifas-Shiman SL, Kleinman K, Ollendorf D, Bousvaros A, Grand RJ, et al. The prevalence and geographic distribution of Crohn’s disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007;5:1424–9.
Kappelman MD, Moore KR, Allen JK, Cook SF. Recent trends in the prevalence of Crohn’s disease and ulcerative colitis in a commercially insured US population. Dig Dis Sci. 2013;58:519–25.
Burisch J, Jess T, Martinato M, Lakatos PL, EpiCom E. The burden of inflammatory bowel disease in Europe. J Crohn's Colitis. 2013;7:322–37.
Kaplan GG. The global burden of IBD: from 2015 to 2025. Nat Rev Gastroenterol Hepatol. 2015;12:720–7.
Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004;126:1504–17.
Shukla R, Thakur E, Bradford A, Hou JK. Caregiver burden in adults with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2018;16:7–15.
Shouval DS, Rufo PA. The role of environmental factors in the pathogenesis of inflammatory bowel diseases: a review. JAMA Pediatr. 2017;171:999–1005.
De Marzo AM, Platz EA, Sutcliffe S, Xu J, Gronberg H, Drake CG, et al. Inflammation in prostate carcinogenesis. Nat Rev Cancer. 2007;7:256–69.
Derikx LA, Smits LJ, van Vliet S, Dekker E, Aalfs CM, van Kouwen MC, et al. Colorectal cancer risk in patients with lynch syndrome and inflammatory bowel disease. Clin Gastroenterol Hepatol. 2017;15:454–8 e451.
Pedersen N, Duricova D, Elkjaer M, Gamborg M, Munkholm P, Jess T. Risk of extra-intestinal cancer in inflammatory bowel disease: meta-analysis of population-based cohort studies. Am J Gastroenterol. 2010;105:1480–7.
Kappelman MD, Farkas DK, Long MD, Erichsen R, Sandler RS, Sorensen HT, et al. Risk of cancer in patients with inflammatory bowel diseases: a nationwide population-based cohort study with 30 years of follow-up evaluation. Clin Gastroenterol Hepatol. 2014;12:265–73 e261.
Loo SY, Vutcovici M, Bitton A, Lakatos PL, Azoulay L, Suissa S et al. Risk of malignant cancers in inflammatory bowel disease. J Crohn's Colitis. 2019.
Burns JA, Weiner AB, Catalona WJ, Li EV, Schaeffer EM, Hanauer SB, et al. Inflammatory bowel disease and the risk of prostate cancer. Eur Urol. 2019;75:846–52.
Jussila A, Virta LJ, Pukkala E, Farkkila MA. Malignancies in patients with inflammatory bowel disease: a nationwide register study in Finland. Scand J Gastroenterol. 2013;48:1405–13.
Hemminki K, Li X, Sundquist J, Sundquist K. Cancer risks in ulcerative colitis patients. Int J Cancer. 2008;123:1417–21.
Jess T, Horvath-Puho E, Fallingborg J, Rasmussen HH, Jacobsen BA. Cancer risk in inflammatory bowel disease according to patient phenotype and treatment: a Danish population-based cohort study. Am J Gastroenterol. 2013;108:1869–76.
Jung YS, Han M, Park S, Kim WH, Cheon JH. Cancer risk in the early stages of inflammatory bowel disease in Korean patients: a nationwide population-based study. J Crohn's Colitis. 2017;11:954–62.
So J, Tang W, Leung WK, Li M, Lo FH, Wong MTL, et al. Cancer risk in 2621 Chinese patients with inflammatory bowel disease: a population-based cohort study. Inflamm Bowel Dis. 2017;23:2061–8.
Wilson JC, Furlano RI, Jick SS, Meier CR. A population-based study examining the risk of malignancy in patients diagnosed with inflammatory bowel disease. J Gastroenterol. 2016;51:1050–62.
Mosher CA, Brown GR, Weideman RA, Crook TW, Cipher DJ, Spechler SJ, et al. Incidence of colorectal cancer and extracolonic cancers in veteran patients with inflammatory bowel disease. Inflamm Bowel Dis. 2018;24:617–23.
Hemminki K, Li X, Sundquist J, Sundquist K. Cancer risks in Crohn disease patients. Ann Oncol. 2009;20:574–80.
Adami HO, Bretthauer M, Emilsson L, Hernan MA, Kalager M, Ludvigsson JF, et al. The continuing uncertainty about cancer risk in inflammatory bowel disease. Gut. 2016;65:889–93.
Herrinton LJ, Liu L, Levin TR, Allison JE, Lewis JD, Velayos F. Incidence and mortality of colorectal adenocarcinoma in persons with inflammatory bowel disease from 1998 to 2010. Gastroenterology. 2012;143:382–9.
van den Heuvel TR, Wintjens DS, Jeuring SF, Wassink MH, Romberg-Camps MJ, Oostenbrug LE, et al. Inflammatory bowel disease, cancer and medication: cancer risk in the Dutch population-based IBDSL cohort. Int J Cancer. 2016;139:1270–80.
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: a systematic analysis for the global burden of disease study. JAMA Oncol. 2018;4:1553–68.
Sfanos KS, Yegnasubramanian S, Nelson WG, De Marzo AM. The inflammatory microenvironment and microbiome in prostate cancer development. Nat Rev Urol. 2018;15:11–24.
Sfanos KS, Joshu CE. IBD as a risk factor for prostate cancer: what is the link? Nat Rev Urol. 2019;16:271–2.
Ni J, Wu GD, Albenberg L, Tomov VT. Gut microbiota and IBD: causation or correlation? Nat Rev Gastroenterol Hepatol. 2017;14:573–84.
Porter CM, Shrestha E, Peiffer LB, Sfanos KS. The microbiome in prostate inflammation and prostate cancer. Prostate Cancer Prostatic Dis. 2018;21:345–54.
Biancone L, Onali S, Petruzziello C, Calabrese E, Pallone F. Cancer and immunomodulators in inflammatory bowel diseases. Inflamm Bowel Dis. 2015;21:674–98.
Pascal V, Pozuelo M, Borruel N, Casellas F, Campos D, Santiago A, et al. A microbial signature for Crohn’s disease. Gut. 2017;66:813–22.
Yaeger R, Shah MA, Miller VA, Kelsen JR, Wang K, Heins ZJ, et al. Genomic alterations observed in colitis-associated cancers are distinct from those found in sporadic colorectal cancers and vary by type of inflammatory bowel disease. Gastroenterology. 2016;151:278–87 e276.
This work was supported by the Fundamental Research Funds for the Central Universities (JUSRP11951); Public Health Research Center at Jiangnan University (JUPH201823); Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University (JUGW201802).
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The authors declare that they have no conflict of interests.
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Ge, Y., Shi, Q., Yao, W. et al. The association between inflammatory bowel disease and prostate cancer risk: a meta-analysis. Prostate Cancer Prostatic Dis 23, 53–58 (2020). https://doi.org/10.1038/s41391-019-0177-7
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