By | January 3, 2019

Researchers say inflammatory bowel disease raises the risk of prostate cancer. They urge screenings for men with this ailment.

Crohn’s disease is a painful digestive condition that has been associated with an increased risk of colon cancer.

But according to a recent study, that’s not the only worry.

A 20-year study from Northwestern Medicine in Illinois finds that men with inflammatory bowel disease may have a 4 to 5 times greater risk of developing prostate cancer.

Crohn’s disease and ulcerative colitis are two types of inflammatory bowel disease (IBD), a chronic condition that tends to worsen gradually with time. Almost 2 million people in the United States experience some form of IBD.

“Inflammatory bowel disease is on the rise worldwide, the exact reasons why remain unclear,” Dr. Hardeep Singh, gastroenterologist at St. Joseph Hospital in Southern California, told Healthline.

According to the Centers for Disease Control and Prevention (CDC), Crohn’s causes inflammation that can affect any part of the entire digestive tract, while ulcerative colitis only affects the colon (large intestine) and the rectum.

Both conditions are believed to involve an abnormal response by the immune system. Previous research has established a link between IBD and colon cancer.

A 20-year study

From 1996 to 2017, researchers looked at 10,000 men, slightly more than 1,000 of which had been diagnosed with IBD.

The study participants ranged from under 40 to more than 70-years old.

Prostate specific antigen (PSA) tests and targeted biopsies were used to determine prostate cancer risk and to make prostate cancer diagnoses.

Researchers found that those with IBD were much more likely to have elevated PSA levels and to eventually develop prostate cancer.

“I conducted this study because many men with IBD delayed seeing me for their high PSA levels because they thought it was due to their bowel inflammation and not a prostate issue,” Dr. Shilajit D. Kundu, associate professor of urology and chief of urologic oncology in the department of urology at Northwestern Medicine and lead study author, told Healthline.

The study found a significantly increased risk of prostate cancer in men with IBD who were at the recommended age to begin PSA screening.

It’s also the first study to find an increased risk of the more aggressive type of prostate cancer in men with IBD.

“I wanted to provide much needed data to help guide medical care providers on how to treat these men,” Kundu said.

Common cancer in men

Prostate cancer is the second highest cancer risk for men and one of the most often fatal.

“Urinary symptoms of prostate cancer are very similar to the symptoms of a benign enlarged prostate. That makes it more challenging to detect malignancies by symptom,” Dr. Sean Cavanaugh, director of Cancer Treatment Centers of America Genitourinary Cancer Institute in Atlanta, told Healthline.

However, by the time symptoms become noticeable, the disease has typically become advanced.

Cavanaugh said symptoms of later-stage disease might include blood in the urine or unexplained, worsening bone pain.

“An increase in urinary frequency, urgency, dribbling, and getting up at night to urinate should be discussed with your doctor,” advised Cavanaugh.

The American Cancer Society recommends men look into PSA screening by age 50, sooner if there is a family history of prostate cancer. African-American men have higher prostate cancer rates.

“Men with IBD have a significantly increased risk of being diagnosed with prostate cancer compared to a man of average risk in his lifetime,” said Kundu, “so I think we may want to screen them more carefully or at least consider them as a group that we should consider screening carefully.”

Colorectal cancer prevention

The lifetime risk of developing colorectal cancer is about 1 in 22 for men, according to the American Cancer Society.

Colorectal cancer is an umbrella term for any cancer that starts in the large intestine or rectum. This cancer typically begins as a growth (polyp) on the inner lining of the colon or rectum.

The odds a polyp will change into cancer depends on what type it is.

“There are two main types of polyps in the colon — hyperplastic polyps and adenomatous polyps,” said Singh. “While adenomas are precancerous in nature, hyperplastic polyps are benign.”

“In most cases, colon cancer is preventable if patients are screened appropriately,” Singh added. “Most cancers occur after the age of 50. So, if patients undergo a baseline colonoscopy at age 50, any precancerous polyps can be removed.”

The bottom line

IBD can increase the risk of developing colorectal cancer.

New research has now concluded that men with IBD also have a significantly greater risk of developing prostate cancer.

Prostate cancer is the second most common fatal cancer in men and often occurs without any symptoms.

Both colorectal and prostate cancer can be detected by regular screening starting at age 50.

Men with IBD may benefit from beginning PSA screening earlier.

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