Introduction: High Grade Prostatic Intraepithelial Neoplasia (HGPIN) was\noriginally thought to be a cancer precursor, but subsequent data has questioned\nits prognostic significance. We analyzed a large cohort of men diagnosed\nwith HGPIN for subsequent occurrence of prostate cancer. Methods:\nFrom 2001 to 2011, we identified 567 men with isolated HGPIN and followed\nthem for subsequent diagnosis of prostate cancer. Results: Two hundred and\nfive patients were followed (median 5.9 years) without biopsy and remained\nclinically free of prostate cancer. The remaining 362 men underwent repeat\nbiopsies and 133 (37%) were diagnosed with prostate cancer. The number of\ncores of HGPIN and whether they were unilateral or bilateral was not predictive\nfor subsequent diagnosis of cancer. Prostate specific antigen was the only\nstatistically significant predictor for prostate cancer. Conclusions: We found\nthe incidence of cancer after a diagnosis of HGPIN to be 37%, which is consistent\nwith other published series. This is only marginally higher than in patients\nre-biopsied after a prior benign biopsy. It appears that isolated HGPIN\nhas only a small predictive value for subsequent diagnosis of prostate cancer.\nTherefore the finding of HGPIN should be used only in conjunction with\nother risk factors and patient considerations in deciding whether to proceed\nwith further prostate biopsies.
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