Prostate cancer patients may have an increased risk of coexisting advanced colorectal neoplasms
Received 14 April 2016
Accepted for publication 27 July 2016
Published 9 September 2016 Volume 2016:9 Pages 5611—5617
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Manfred Beleut
Peer reviewer comments 2
Editor who approved publication: Professor Min Li
Sun-Hye Ko,1,2 Myong Ki Baeg,2,3 Woong Jin Bae,4 Pumsoo Kim,3 Myung-Gyu Choi2
1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; 2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 3Department of Internal Medicine, International St Mary’s Hospital, Catholic Kwandong University, Incheon, South Korea; 4Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
Background/aims: Patients being treated for prostate cancer (PCa) have an increased risk of developing colorectal cancer. However, whether PCa patients are inherently at a higher risk of colorectal neoplasms (CRNs) is unknown. We aimed to investigate the risk of CRNs in PCa patients.
Materials and methods: Patients who had been diagnosed with PCa at a tertiary medical center and had colonoscopy within 1 year of the PCa diagnosis were investigated. Patients were propensity-matched 1:2 by age and body mass index to asymptomatic control subjects who had undergone colonoscopy for routine health screening. CRN was defined as histological confirmation of an adenoma or adenocarcinoma component. Advanced CRN was defined as any of the following: 1) histological findings of high-grade dysplasia, 2) inclusion of villous features, 3) tumor ≥1 cm in size, or 4) presence of an adenocarcinoma. Risk factors for CRN and advanced CRN were evaluated by univariate and multivariate analysis.
Results: A total of 191 patients diagnosed with PCa had colonoscopies within 1 year of PCa diagnosis. Of these, 23 patients with a history of previous malignancy and seven with incomplete colonoscopies were excluded, leaving 161 patients in the PCa group. Although presence of PCa was not a significant risk factor for CRN by multivariate analysis, PCa was a significant risk factor for advanced CRN (odds ratio [OR] 3.300; 95% confidence interval [CI] 1.766–6.167; P<0.001). Other significant risk factors for advanced CRN were age (OR 1.050; 95% CI 1.003–1.009; P=0.036) and body mass index (OR 1.205; 95% CI 1.067–1.361; P=0.003), whereas aspirin use (OR 0.414; 95% CI 0.173–0.990; P=0.047) was a preventive factor.
Conclusion: The risk of advanced CRN may be significantly increased in patients with PCa. Patients with PCa should have a colonoscopy at the time of PCa diagnosis.
Keywords: colorectal neoplasms, prostate cancer, colonoscopy, colorectal adenoma and carcinoma
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