Chronic prostate inflammation may predispose for cancer

Atlanta-Chronic prostatic inflammation may increase the chance that a man will develop prostate cancer, suggesting that men with inflammation on biopsy may need to be followed more closely and perhaps even be re-biopsied more aggressively, even if there is no evidence of cancer.

That was the conclusion reached by a team from Case Western Reserve University, Cleveland, which reported its findings at the AUA annual meeting here.

Of those 144, 54 (39%) had post-atrophic hyperplasia/proliferative inflammatory atrophy (PAH/PIA), while 22 (15%) showed only inflammation, another 22 had simple atrophy, 29 (20%) had adenocarcinoma, 12 (8%) had high-grade prostatic intraepithelial neoplasia (HGPIN), and five (3%) had atypical small-acinar proliferation (ASAP).

Repeat biopsies revealing

Perhaps the most valuable finding came when the group examined repeat biopsies done within 5 years in patients with chronic inflammation.

Almost 20% of those were found to have adenocarcinoma, including 15 patients with initial PAH/PIA lesions, seven with initial HGPIN lesions, six with only chronic inflammation, and one with initial ASAP.

The authors noted that HGPIN was subsequently found in seven men with PAH/PIA and in two with initial simple atrophy.

"In sharp contrast to that were the 33 cases initially showing no inflammation," Dr. MacLennan said. "Adenocarcinoma was subsequently found in only 6% [two cases] of those."

Dr. MacLennan suggested that potential etiologic factors in the genesis of chronic prostatic inflammation include imbalanced diet, exposure to environmental pollutants, high testosterone levels, viral infection, or genetic predisposition.