Inflammation in benign prostate tissue and prostate cancer in the finasteride arm of the Prostate Cancer Prevention Trial.

A previous analysis of the placebo arm of the Prostate Cancer Prevention Trial (PCPT) reported 82% overall prevalence of intraprostatic inflammation and identified a link between inflammation and higher-grade prostate cancer and serum PSA.

Here we studied these associations in the PCPT finasteride arm.

Prostate cancer cases (N=197) detected either on a clinically indicated biopsy or on protocol-directed end-of-study biopsy, and frequency-matched controls (N=248) with no cancer on an end-of-study biopsy were sampled from the finasteride arm. Inflammation in benign prostate tissue was visually assessed using digital images of H&E stained sections. Logistic regression was used for statistical analysis.

In the finasteride arm, 91. 6% of prostate cancer cases and 92. 4% of controls had at least one biopsy core with inflammation in benign areas; p < 0. 001 for difference compared to placebo arm. Overall, the odds of prostate cancer did not differ by prevalence (OR=0. 90, 95% CI 0. 44-1. 84) or extent (P-trend=0. 68) of inflammation. Inflammation was not associated with higher-grade disease (prevalence: OR=1. 07, 95% CI 0. 43-2. 69). Furthermore, mean PSA concentration did not differ by the prevalence or extent of inflammationin either cases or controls.

The prevalence of intraprostatic inflammation was higher in the finasteride than placebo arm of the PCPT, with no association with higher-grade prostate cancer.

Finasteride may attenuate the association between inflammation and higher-grade prostate cancer. Moreover, the missing link between intraprostatic inflammation and PSA suggests that finasteride may reduce inflammation-associated PSA elevation.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2015 Dec 29 [Epub ahead of print]

Teemu Murtola, Bora Gurel, Martin Umbehr, M Scott Lucia, Ian M Thompson, Phyllis J Goodman, Alan R Kristal, Howard L Parnes, Scott M Lippman, Siobhan Sutcliffe, Sarah B Peskoe, John R Barber, Charles G Drake, William G Nelson, Angelo M De Marzo, Elizabeth A Platz

University of Tampere. , Department of Pathology, Kocaeli University School of Medicine. , University of Zurich. , Pathology, University of Colorado. , Department of Urology, University of Texas Health Sciences Center San Antonio. , Fred Hutchinson Cancer Research Center. , Fred Hutchinson Cancer Research Center. , Division of Cancer Prevention, National Cancer Institute. , University of California, San Diego, Moores Cancer Center. , Washington University School of Medicine. , Epidemiology, Johns Hopkins University School of Public Health. , Epidemiology, Johns Hopkins University School of Public Health. , Oncology, Johns Hopkins University School of Medicine. , Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine. , Department of Pathology, Johns Hopkins University. , Epidemiology, Johns Hopkins University School of Public Health.

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