Editorial comment on: Prostate growth and prevalence of prostate diseases in early onset spinal cord injuries.
OBJECTIVES To determine the incidence and characteristics of prostate cancer in men with spinal cord injury (SCI). Little is known about the characteristics of prostate cancer in men with SCI, because prostate cancer screening is not aggressively performed in this population. METHODS In one fiscal year, 648 men with SCI older than age 50 years were actively enrolled with the SCI service, 20,949 able-bodied men older than age 50 years were actively enrolled in the outpatient clinic database, and 945 patients with prostate cancer were in the cancer registry at our facility. These three databases were cross-referenced for prostate cancer diagnosis and stage and compared with the presence of SCI. RESULTS Of the 648 patients with SCI, 12 patients with a prostate cancer diagnosis that preceded their injury were excluded. Of the remaining 636 patients, 11 (1.7%) had been diagnosed with prostate cancer since their injury. In contrast, of the 20,949 able-bodied men older than age 50 years seen at our facility in fiscal year 1999, 919 (4.4%) had prostate cancer. Of the patients with SCI and prostate cancer, 7 (63.6%) had locally advanced (Stage T3) or metastatic prostate cancer compared with 267 (29.1%) in the able-bodied population (P = 0.012). CONCLUSIONS Although the proportion of patients with a prostate cancer diagnosis was greater in the able-bodied patients, the prostate cancer detected in the patients with SCI tended to be of a more advanced stage and grade. The difference was likely a result of the decreased use of prostate cancer screening in this population.