Discover oncology · 2025
Benign prostatic hyperplasia and risk of urological cancers: a prospective cohort study based on the UK biobank.
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Guo Jinjing, Zhou Liang, He Jiaming, Pan Xinkai, Liu Dingwen, Li Jiaren, Zhou Qing, Wang Long
Аннотация
BACKGROUND: Benign prostatic hyperplasia (BPH) is considered a risk factor for certain urological cancers; however, current evidence remains ambiguous. This study aimed to assess the relationship between BPH and risk of urological cancers, including any potential causal connections.
METHODS: Between 2006 and 2010, we identified 190,829 participants in the UK Biobank. We used the Cox proportional hazards regression model to calculate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We balanced the covariate differences between the BPH and non-BPH groups using propensity score matching (PSM). We also performed a two-sample Mendelian randomization (MR) analysis to investigate the causal link between BPH and risks of urological cancers.
RESULTS: Participants with BPH had significantly higher risks of prostate cancer (PCa) (pre-PSM HR 1.28, 95% CI 1.20-1.36, n = 1,127 cases; post-PSM 1.30, 1.19-1.41), bladder cancer (BCa) (pre-PSM 1.49, 1.17-1.91, n = 79; post-PSM 1.92, 1.32-2.80) and renal cell carcinoma (RCC) (pre-PSM 1.29, 1.02-1.64, n = 79; post-PSM 1.41, 1.01-1.99) compared to non-BPH participants. MR analysis revealed that BPH has a positive causal effect on PCa (OR 1.002, 1.000-1.004) and BCa (OR 1.001, 1.000-1.002). This association between BPH and PCa or BCa is significantly moderated by age (P < 0.001), and is more pronounced in white individuals and those with sufficient physical activity.
CONCLUSIONS: This study revealed that people with BPH have a higher risk of PCa, RCC and BCa. There is a significant causal relationship between BPH and an increased risk of PCa and BCa.
TRIAL REGISTRATION: Not applicable. This study is a prospective observational analysis based on the UK Biobank cohort (application number 135237) and did not involve any interventional procedures that would require clinical-trial registration.
METHODS: Between 2006 and 2010, we identified 190,829 participants in the UK Biobank. We used the Cox proportional hazards regression model to calculate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We balanced the covariate differences between the BPH and non-BPH groups using propensity score matching (PSM). We also performed a two-sample Mendelian randomization (MR) analysis to investigate the causal link between BPH and risks of urological cancers.
RESULTS: Participants with BPH had significantly higher risks of prostate cancer (PCa) (pre-PSM HR 1.28, 95% CI 1.20-1.36, n = 1,127 cases; post-PSM 1.30, 1.19-1.41), bladder cancer (BCa) (pre-PSM 1.49, 1.17-1.91, n = 79; post-PSM 1.92, 1.32-2.80) and renal cell carcinoma (RCC) (pre-PSM 1.29, 1.02-1.64, n = 79; post-PSM 1.41, 1.01-1.99) compared to non-BPH participants. MR analysis revealed that BPH has a positive causal effect on PCa (OR 1.002, 1.000-1.004) and BCa (OR 1.001, 1.000-1.002). This association between BPH and PCa or BCa is significantly moderated by age (P < 0.001), and is more pronounced in white individuals and those with sufficient physical activity.
CONCLUSIONS: This study revealed that people with BPH have a higher risk of PCa, RCC and BCa. There is a significant causal relationship between BPH and an increased risk of PCa and BCa.
TRIAL REGISTRATION: Not applicable. This study is a prospective observational analysis based on the UK Biobank cohort (application number 135237) and did not involve any interventional procedures that would require clinical-trial registration.