Presentation Authors: Kerri Beckmann, Beth Russell, Debra Josephs, Hans Garmo, London, United Kingdom, Christel Haggstrom, Umea, Sweden, Lars Holmberg, London, United Kingdom, Par Stattin, Uppsala, Sweden, Mieke Van Hemelrijck*, London, United Kingdom, Jan Adolfsson, Stockholm, Sweden
Introduction: Chronic inflammation has been postulated to play a role in cancer aetiology but evidence in the case of prostate cancer (PCa) is unclear. The objective of this study was to determine whether a history of chronic inflammatory diseases (CIDs) or exposure to anti-inflammatory medications (AIMs) is associated with risk of PCa.
Methods: A case-control design was used: 55,937 cases (all men diagnosed with prostate cancer between 2007-2012) and 279,618 age-matched population controls were selected from the Prostate Cancer Database Sweden (PCBaSe). History of CIDs and AIMs were determined through linkage with national patient and drug registers. Conditional logistic regression was used to investigate associations with any exposure, and for specific disease and medication subtypes, and additionally, according to exposure time/dose.
Results: : Odds of PCa diagnosis were increased slightly among men with prior history of any CIDs (OR: 1.08; 95%CI: 1.04-1.12). No association was seen for advanced PCa (high risk/ non-localised), except specifically for prostatitis. For most CIDs subtypes, odds were elevated when first presenting with CIDs during the previous 12 months. The only subtype showing elevated odds for >5 years exposure was allergies/asthma (OR: 1.21; 95%CI: 1.04-1.40). Odds were increased among men with any AIMS exposure (OR: 1.26; 95%CI: 1.24-1.29) and for most AIMs subtypes. Inhaled glucocorticoids were the only subtype to show a trend with increased cumulative dose (p < 0.001).
Conclusions: Results of this population-based study suggest that, for the most part, any elevated risk in PCa with prior CIDs or AIMs is likely due to detection bias, given the higher risk with short exposure and lack of dose response. Further investigation may be warranted in relation to allergies (predominantly asthma) and use of inhaled glucocorticoids.
Source of Funding: Swedish Cancer Society; NHMRC