Inflammatory Bowel Disease and the Risk of Prostate Cancer

Jacob A. Burns, Adam B. Weiner, William J. Catalona, Eric V. Li, Edward M. Schaeffer, Stephen B. Hanauer, Scott Strong, James Burns, Maha H.A. Hussain, Shilajit D. Kundu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: There are limited data examining the risk of prostate cancer (PCa) in patients with inflammatory bowel disease (IBD). Objective: To compare the incidence of PCa between men with and those without IBD. Design, setting, and participants: This was a retrospective, matched-cohort study involving a single academic medical center and conducted from 1996 to 2017. Male patients with IBD (cases = 1033) were randomly matched 1:9 by age and race to men without IBD (controls = 9306). All patients had undergone at least one prostate-specific antigen (PSA) screening test. Outcome measurements and statistical analysis: Kaplan-Meier and multivariable Cox proportional hazard models, stratified by age and race, evaluated the relationship between IBD and the incidence of any PCa and clinically significant PCa (Gleason grade group ≥2). A mixed-effect regression model assessed the association of IBD with PSA level. Results and limitations: PCa incidence at 10 yr was 4.4% among men with IBD and 0.65% among controls (hazard ratio [HR] 4.84 [3.34–7.02] [3.19–6.69], p < 0.001). Clinically significant PCa incidence at 10 yr was 2.4% for men with IBD and 0.42% for controls (HR 4.04 [2.52–6.48], p < 0.001). After approximately age 60, PSA values were higher among patients with IBD (fixed-effect interaction of age and patient group: p = 0.004). Results are limited by the retrospective nature of the analysis and lack of external validity. Conclusions: Men with IBD had higher rates of clinically significant PCa when compared with age- and race-matched controls. Patient summary: This study of over 10 000 men treated at a large medical center suggests that men with inflammatory bowel disease may be at a higher risk of prostate cancer than the general population. In a retrospective matched-cohort study, patients with inflammatory bowel disease (IBD) who underwent prostate-specific antigen-based screening had higher rates of any and clinically significant (Gleason ≥7) prostate cancer than age- and race-matched patients without IBD. Prospective studies should investigate the relationship between IBD and prostate cancer.

Original languageEnglish (US)
Pages (from-to)846-852
Number of pages7
JournalEuropean urology
Issue number5
StatePublished - May 2019


  • Inflammatory bowel diseases
  • Prostate-specific antigen
  • Prostatic neoplasm

ASJC Scopus subject areas

  • Urology


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