INCIDENCE OF BENIGN PROSTATIC HYPERPLASIA IN TESTICULAR CANCER SURVIVORS IN THE VETERANS AFFAIRS HEALTH SYSTEM

Abstract: Testosterone and prostatic inflammation have been postulated to influence the development of benign prostatic hyperplasia (BPH). Our study aims to evaluate the incidence of BPH in Testicular Cancer (TCa) survivors, focusing on the impact of chemotherapy and post TCa diagnosed hypogonadism. We conducted a retrospective cohort analysis of US veterans diagnosed with TCa between 1990 to 2021, using the Veterans affairs database. BPH was defined using International Classification of Diseases (ICD) codes, Current Procedural Terminology (CPT) codes, or a 6-month prescription of medications. Associations with BPH were analysed, stratifying the cohort by receipt of chemotherapy and presence of hypogonadism. Multivariable cox regression models were used to determine statistical significance (p-value <0.05). Our cohort included 2038 TCa survivors with a median age at diagnosis of 41 years. On multivariable cox regression analysis, receipt of chemotherapy was not significantly associated with incidence of BPH (p-value= 0.13). When stratified by diagnosis of hypogonadism prior to BPH, no significant associations were found on univariable (p=0.81) as well as multivariable (p=0.65) analyses. In the multivariable model, age at diagnosis was significantly associated with an increased incidence of BPH (Hazard ratio: 1.06, p<0.001). Our findings demonstrate that age is a significant factor associated with development of BPH in this population, while suggesting that chemotherapy for TCa and hypogonadism might not substantially alter the development of BPH.