This large-scale meta-analysis, incorporating studies from several population-based studies, evaluated the association between inflammatory bowel disease (IBC) and prostate cancer (Pca). Emerging evidence has suggested that IBD is a risk factor for extra-intestinal malignancies which may be due to an aberrant immune response. It is established that chronic prostate inflammation may play a key role in the development of PCa; yet, no studies have demonstrated this associated consistently. The inclusion criteria was strict with minimal sample size set of >1000 patients and outcomes measured for greater than three years of follow-up. In total, nine studies were identified for this meta-analysis. For case-control studies (n=3) the pool relative risk of PCa was 1.81 (95% CI: 1.43-2.29); however, a subgroup analysis of ulcerative colitis (UC) or Crohn’s disease (CD) patients could not be performed due to lack of information of IBD subtype. For cohort studies, the pooled standardised incidence ratio was 1.33 (95% CI 1.03-1.71). In the subgroup analysis the PCa risk was higher in UC (SIR=1.58, 95% CI 1.09-2.30), however the findings with CD were non-significant. The longest follow-up time for patients was 40 years. Funnel plots did not determine a significant publication bias with included studies. One of the main limitations of the study was the inability to account for some of the confounders such as prostate specific antigen screening and family history of prostate cancer due to the included studies. In addition, they were unable to differentiate between clinically significant and insignificant PCa disease. Nevertheless, this is an interesting study that demonstrates men with IBD (especially UC) have a significant elevated PCa risk, however further well-designed studies are warranted.
Ulcerative colitis has a positive association with prostate cancer risk
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