A prospective study of chronic inflammation in benign prostate tissue and risk of prostate cancer: Linked PCPT and SELECT cohorts

Elizabeth A. Platz, Ibrahim Kulac, John R. Barber, Charles G. Drake, Corinne E. Joshu, William G. Nelson, M. Scott Lucia, Eric A. Klein, Scott M. Lippman, Howard L. Parnes, Ian M. Thompson, Phyllis J. Goodman, Catherine M. Tangen, Angelo M. De Marzo

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background: We leveraged two trials to test the hypothesis of an inflammation–prostate cancer link prospectively in men without indication for biopsy. Methods: Prostate Cancer Prevention Trial (PCPT) participants who had an end-of-study biopsy performed per protocol that was negative for cancer and who subsequently enrolled in the Selenium and Vitamin E Cancer Prevention Trial (SELECT) were eligible. We selected all 100 cases and sampled 200 frequency-matched controls and used PCPT end-of-study biopsies as "baseline." Five men with PSA > 4 ng/mL at end-of-study biopsy were excluded. Tissue was located for 92 cases and 193 controls. We visually assessed inflammation in benign tissue. We estimated ORs and 95% confidence intervals (CI) using logistic regression adjusting for age and race. Results: Mean time between biopsy and diagnosis was 5.9 years. In men previously in the PCPT placebo arm, 78.1% of cases (N = 41) and 68.2% of controls (N = 85) had at least one baseline biopsy core (5 evaluated per man) with inflammation. The odds of prostate cancer (N = 41 cases) appeared to increase with increasing mean percentage of tissue area with inflammation, a trend that was statistically significant for Gleason sum <4+3 disease (N = 31 cases; vs. 0%, >0–<1.8% OR = 1.70, 1.8–<5.0% OR = 2.39, 5% OR = 3.31, Ptrend = 0.047). In men previously in the finasteride arm, prevalence of inflammation did not differ between cases (76.5%; N = 51) and controls (75.0%; N = 108). Conclusions: Benign tissue inflammation was positively associated with prostate cancer. Impact: This first prospective study of men without biopsy indication supports the hypothesis that inflammation influences prostate cancer development.

Original languageEnglish (US)
Pages (from-to)1549-1557
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Issue number10
StatePublished - Oct 1 2017

ASJC Scopus subject areas

  • Epidemiology
  • Oncology


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