良性攝護腺增生患者與後續罹患膀胱癌增加的風險：在亞洲台灣族群的研究
廖丞晞1,2,4 方楚文3 莫之欣6 吳汐淇2,5
1國軍台中總醫院泌尿外科; 2中國醫藥大學臨床醫學及生物醫學研究所; 3奇美醫學中心外科部泌尿外科; 4國防醫學院臨床醫學研究所; 5中國醫藥大學附設醫院創傷及急診中心; 6中國醫藥大學附設醫院健康資料管理辦公室
ASSOCIATION OF BENIGN PROSTATIC HYPERPLASIA AND SUBSEQUENT RISK OF CANCER: AN ASIAN POPULATION COHORT STUDY IN TAIWAN
Cheng-Hsi Liao1,2,4 , Chu-Wen Fang3 , Chih-Hsin Muo6, and Shi-Chi Wu2,5
1 Department of Urology, Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C.;
2 Graduate Institute of Clinical Medical Science & Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.;
3 Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan, R.O.C;
4 Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C.;
5 Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.;
6Management Office for Health Data, China Medical University and Hospital, R.O.C.
Purpose:
There were few human studies and lack of solid evidences to elucidate the linkage between benign prostatic hyperplasia (BPH) and bladder cancer. Therefore, we perform this longitudinal cohort study to investigate the associations between BPH and subsequent bladder cancer risks.
Materials and Methods:
We identified 35092 study subjects, including 17546 BPH patients (BPH cohort) and 17546 comparisons (comparison cohort) from National Health Insurance database. The Comparison cohort were frequency matched with age, and index-year. We then measured subsequent bladder cancer rate (per 1000 person-years) in two cohorts. The hazard ratio (HR) and 95% confidence intervals (CIs) of bladder cancer were estimated by Cox proportional hazard regression.
Results:
The BPH patients had a 4.69- and 4.05-fold bladder cancer risk in crude and adjusted Cox model (95% CI = 4.15-6.99 and 2.67-6.12) when compared to comparisons. There were similar result in age, and comorbidity stratified analyses. The incidence were highest in patients aged 65-74 years old. In addition, BPH patients with chronic kidney disease had a high bladder cancer risk (HR = 6.26, 95% CI = 3.41 - 11.5). Furthermore, regarding the association for bladder cancer and transurethral prostatectomy (TURP), BPH patients underwent TURP had a higher risk of bladder cancer (HR = 6.14, 95% CI = 3.68-10.2) than those who without TURP (HR = 3.67, 95% CI = 2.41 - 5.61).
Conclusions:
In this long-term cohort study, patients with BPH are at an increased risk of subsequent bladder cancer, which were more prominent in the elderly patients. However, further studies are needed.