Acute urinary retention tied to increased risk of certain cancers

(Reuters Health) – People who experience acute urinary retention are more likely to be diagnosed with prostate or urinary tract cancers in subsequent months, a recent study suggests.

Researchers examined data on 75,983 adults aged 50 and older who were admitted to the hospital with acute urinary retention between 1995 and 2017; most patients (82.6%) were male. The primary goal of the study was to assess the absolute risk of urogenital, colorectal, and neurological cancers among patients with acute urinary retention as compared with the general population.

Within three months of the diagnosis of acute urinary retention, researchers identified an excess cancer risk of 218 cases per 1,000 person-years for prostate cancer in men and 24 excess cases per 1,000 person-years for genital cancers in women. In addition, there was an excess risk at three months of 56 urinary cancer cases per 1,000 person-years, 12 colorectal cancer cases per 1,000 person-years, and 2 neurological cancer cases per 1,000 person-years.

“We conducted this study because we thought that acute urinary retention could potentially be a presenting sign of prostate cancer and some other cancers,” said lead study author Dr. Maria Bisgaard Bengtsen of the department of clinical epidemiology at Aarhus University in Denmark.

“If so, admission with a first-time acute urinary retention could be an opportunity to diagnose an occult cancer,” Dr. Bengtsen said by email. “These cancers have been mentioned as theoretical causes of acute urinary retention in the literature, yet our study is the first to quantify this risk.”

The median follow-up period in the study was 3.3 years. A total of 27,410 people (36.1%) were followed for at least five years.

Patients had a median age of 76 years at the time of their first diagnosis of acute urinary retention. At this point, many of them had a prior urogenital diagnosis (48%), a previous neurological diagnosis (27.3%), or had been diagnosed with diabetes (13.2%).

The excess risk of cancer following a first diagnosis of acute urinary retention was seen only for three months afterward for several types of cancers studied, the study team reports in The BMJ.

However, at 12 months post-diagnosis there was still an excess prostate cancer risk of 21 cases per 1,000 person-years.

And, in women, there was an excess risk of urinary tract cancers from one to five years after a diagnosis of acute urinary retention, with 52 cases observed in this group compared with 28 expected cases based on findings from the general population.

One limitation of the study is that it included only patients admitted to the hospital for acute urinary retention, and it’s possible some cases were treated in other settings, the authors note.

“We do not consider the association between acute urinary retention and cancer to be causal, and therefore treating or preventing urinary retention is unlikely to prevent cancer,” Dr. Bengtsen said. “Acute urinary retention is rather likely to be a presenting sign of occult cancer, which should therefore possibly be considered in patients aged 50 years or above with urinary retention and no obvious cause.”