A case-control study of chronic prostatitis/chronic pelvic pain syndrome and colorectal cancer

Abstract

Study Type - Symptom prevalence (case control). Level of Evidence 2b. What's known on the subject? and What does the study add? Associations are well established between intestinal infection/inflammation or inflammatory bowel diseases and colorectal cancer (CRC). Our study found an association between CRC and previously diagnosed chronic prostatitis/chronic pelvic pain syndrome. Patients with CRC had a 1.45-fold higher risk of having a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome than controls. This phenomenon was found to be more prominent in subjects younger than 60 years.

Objective: • To estimate the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and colorectal cancer (CRC) using a nationwide population-based data set.

Patients and methods: • This case-control study used data sourced from the Taiwan Longitudinal Health Insurance Database. • The cases comprised 2899 patients with CRC and 14 995 randomly selected subjects as controls. • We used conditional logistic regression to examine the association between CRC and previous diagnosis of CP/CPPS.

Results: • Of the sampled patients, 531(3.05%) had been diagnosed with CP/CPPS before the index date, with 123 (4.24% of the patients with CRC) coming from the cases and 408 individuals (2.81% of patients without CRC) coming from the controls. • Conditional logistic regression analysis revealed that cases were more likely to have CP/CPPS than controls (odds ratio 1.45, 95% CI 1.17-1.79, P < 0.001) after adjusting for the monthly income, geographic location, urbanization level, hypertension, diabetes, renal disease, obesity and cystic kidney disease. • In subgroup analysis, we found the magnitude of the association to be higher in subjects younger than 60 years (age 40-49, odds ratio 2.01; 95% CI 2.04-3.58 and aged 50-59, 2.40, 95% CI 1.48-3.87, both P < 0.001) than among other age groups.

Conclusion: • We conclude that CP/CPPS patients are at higher risk for CRC, especially in males under 60 years of age.