The Role of Prostatitis in Prostate Cancer: Meta-Analysis

Abstract

ObjectiveUse systematic review methods to quantify the association between prostatitis and prostate cancer, under both fixed and random effects model. Evidence AcquisitionCase control studies of prostate cancer with information on prostatitis history. All studies published between 1990-2012, were collected to calculate a pooled odds ratio. Selection criteria: the selection criteria are as follows: human case control studies; published from May 1990 to July 2012; containing number of prostatitis, and prostate cancer cases. Evidence SynthesisIn total, 20 case control studies were included. A significant association between prostatitis and prostate cancer was found, under both fixed effect model (pooled OR=1.50, 95%CI: 1.39-1.62), and random effects model (OR=1.64, 95%CI: 1.36-1.98). Personal interview based case control studies showed a high level of association (fixed effect model: pooled OR=1.59, 95%CI: 1.47-1.73, random effects model: pooled OR= 1.87, 95%CI: 1.52-2.29), compared with clinical based studies (fixed effect model: pooled OR=1.05, 95%CI: 0.86-1.28, random effects model: pooled OR= 0.98, 95%CI: 0.67-1.45). Additionally, pooled ORs, were calculated for each decade. In a fixed effect model: 1990’s: OR=1.58, 95% CI: 1.35-1.84; 2000’s: OR=1.59, 95% CI: 1.40-1.79; 2010’s: OR=1.37, 95% CI: 1.22-1.56. In a random effects model: 1990’s: OR=1.98, 95% CI: 1.08-3.62; 2000’s: OR=1.64, 95% CI: 1.23-2.19; 2010’s: OR=1.34, 95% CI: 1.03-1.73. Finally a meta-analysis stratified by each country was conducted. In fixed effect models, U.S: pooled OR =1.45, 95%CI: 1.34-1.57; China: pooled OR =4.67, 95%CI: 3.08-7.07; Cuba: pooled OR =1.43, 95%CI: 1.00-2.04; Italy: pooled OR =0.61, 95%CI: 0.13-2.90. In random effects model, U.S: pooled OR=1.50, 95%CI: 1.25-1.80; China: pooled OR =4.67, 95%CI: 3.08-7.07; Cuba: pooled OR =1.43, 95%CI: 1.00-2.04; Italy: pooled OR =0.61, 95%CI: 0.13-2.90.CONCLUSIONS: the present meta-analysis provides the statistical evidence that the association between prostatitis and prostate cancer is significant.

The association between prostatitis and prostate cancer. Systematic review and meta-analysis

“…The prognostic and therapeutic implications of our findings, together with the findings of Dennis et al and Jiang et al (6,7), may be of considerable importance. In this respect, it might be interesting to investigate whether aggressive therapeutic management of chronic prostatitis syndromes may have cancer-preventive potential.…”

“…At the clinical level, a number of studies investigated whether a history of clinical prostatitis may increase the risk of developing prostate cancer. The results of these studies have been meta-analyzed by Jiang et al (6). This work, based on a literature search performed up to July 2012, confirmed previous findings (7) and indicated that clinical prostatitis may be significantly associated with prostate cancer.…”

“…The present meta (6,7). Although calculation of the odds ratio is the most appropriate strategy to retrospectively quantify the association between a disease and a hypothetical risk factor, its interpretation is not always straightforward, and the perception of risk can be often overestimated by readers not familiar with its underlying statistics.…”

Prostate cancer incidence in men with self-reported prostatitis after 15 years of follow-up

“…It has been proposed that chronic inflammatory infiltrate-positive prostatitis may protect against prostate cancer (8). The majority of previous studies included patients with diagnosis of prostate cancer and controls from patients records or interviews (1,2,9). By contrast, the present study used a randomly selected sample of Finnish men surveyed in the 1990s to evaluate the effect of prostatitis on prostate cancer incidence.…”

“…Two previous meta-analyses provided significant evidence of the association between prostatitis and prostate cancer (1,2). There are, however, several studies showing no association or a negative correlation between prostatitis and prostate cancer (3)(4)(5)(6)(7).…”