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Cancer Epidemiology, Biomarkers & Prevention
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Research Articles

Chronic Inflammation in Benign Prostate Tissue Is Associated with High-Grade Prostate Cancer in the Placebo Arm of the Prostate Cancer Prevention Trial

Bora Gurel, M. Scott Lucia, Ian M. Thompson Jr, Phyllis J. Goodman, Catherine M. Tangen, Alan R. Kristal, Howard L. Parnes, Ashraful Hoque, Scott M. Lippman, Siobhan Sutcliffe, Sarah B. Peskoe, Charles G. Drake, William G. Nelson, Angelo M. De Marzo and Elizabeth A. Platz
Bora Gurel
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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M. Scott Lucia
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Ian M. Thompson Jr
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Phyllis J. Goodman
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Catherine M. Tangen
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Alan R. Kristal
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Howard L. Parnes
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Ashraful Hoque
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Scott M. Lippman
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Siobhan Sutcliffe
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Sarah B. Peskoe
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Charles G. Drake
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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William G. Nelson
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Angelo M. De Marzo
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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Elizabeth A. Platz
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Departments of 1Pathology and 2Immunology; 3The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine; 4Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health; 5Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore; 6Division of Cancer Prevention, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; 7University of Colorado School of Medicine, Aurora, Colorado; 8Department of Urology, University of Texas Health Sciences Center San Antonio, San Antonio; 9Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas; 10SWOG Statistical Center; 11Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; 12Moores Cancer Center, University of California San Diego, La Jolla, California; and 13Division of Public Health Sciences and The Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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DOI: 10.1158/1055-9965.EPI-13-1126 Published May 2014
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Abstract

Background: Chronic inflammation is hypothesized to influence prostate cancer development, although a definitive link has not been established.

Methods: Prostate cancer cases (N = 191) detected on a for-cause (clinically indicated) or end-of-study (protocol directed) biopsy, and frequency-matched controls (N = 209), defined as negative for cancer on an end-of-study biopsy, were sampled from the placebo arm of the Prostate Cancer Prevention Trial. Inflammation prevalence and extent in benign areas of biopsy cores were visually assessed using digital images of hematoxylin and eosin–stained sections. Logistic regression was used to estimate associations.

Results: Of note, 86.2% of cases and 78.2% of controls had at least one biopsy core (of three assessed) with inflammation in benign areas, most of which was chronic. Men who had at least one biopsy core with inflammation had 1.78 [95% confidence interval (CI), 1.04–3.06] times the odds of prostate cancer compared with men who had zero cores with inflammation. The association was stronger for high-grade disease (Gleason sum 7–10, N = 94; OR, 2.24; 95% CI, 1.06–4.71). These patterns were present when restricting to cases and controls in whom intraprostatic inflammation was the least likely to have influenced biopsy recommendation because their prostate-specific antigen (PSA) was low (<2 ng/mL at biopsy).

Conclusion: Inflammation, most of which was chronic, was common in benign prostate tissue, and was positively associated with prostate cancer, especially high grade. The association did not seem to be due to detection bias.

Impact: This study supports an etiologic link between inflammation and prostate carcinogenesis, and suggests an avenue for prevention by mitigating intraprostatic inflammation. Cancer Epidemiol Biomarkers Prev; 23(5); 847–56. ©2014 AACR.

Footnotes

  • Note: A Southwest Oncology Group Study S9217.

  • A.M. De Marzo and E.A. Platz share senior authorship for this article.

  • Received October 30, 2013.
  • Revision received January 31, 2014.
  • Accepted February 17, 2014.
  • ©2014 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 23 (5)
May 2014
Volume 23, Issue 5
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Chronic Inflammation in Benign Prostate Tissue Is Associated with High-Grade Prostate Cancer in the Placebo Arm of the Prostate Cancer Prevention Trial
Bora Gurel, M. Scott Lucia, Ian M. Thompson Jr, Phyllis J. Goodman, Catherine M. Tangen, Alan R. Kristal, Howard L. Parnes, Ashraful Hoque, Scott M. Lippman, Siobhan Sutcliffe, Sarah B. Peskoe, Charles G. Drake, William G. Nelson, Angelo M. De Marzo and Elizabeth A. Platz
Cancer Epidemiol Biomarkers Prev May 1 2014 (23) (5) 847-856; DOI: 10.1158/1055-9965.EPI-13-1126

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Chronic Inflammation in Benign Prostate Tissue Is Associated with High-Grade Prostate Cancer in the Placebo Arm of the Prostate Cancer Prevention Trial
Bora Gurel, M. Scott Lucia, Ian M. Thompson Jr, Phyllis J. Goodman, Catherine M. Tangen, Alan R. Kristal, Howard L. Parnes, Ashraful Hoque, Scott M. Lippman, Siobhan Sutcliffe, Sarah B. Peskoe, Charles G. Drake, William G. Nelson, Angelo M. De Marzo and Elizabeth A. Platz
Cancer Epidemiol Biomarkers Prev May 1 2014 (23) (5) 847-856; DOI: 10.1158/1055-9965.EPI-13-1126
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eISSN: 1538-7755
ISSN: 1055-9965

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