Gonorrhea infection increases the risk of prostate cancer in Asian population: a nationwide population-based cohort study

Abstract

This nationwide population-based retrospective cohort study evaluated the risk of developing prostate cancer among patients with gonorrhea. We identified cases of newly diagnosed gonorrhea in men between 2000 and 2010 from the Taiwan National Health Insurance Research Database. Each patient with gonorrhea was matched to four controls, based on age and index year. All subjects were followed up from the index date to December 31, 2010. The Cox proportional hazards regression model was used to assess the risk of prostate cancer. A total of 355 men were included in the study group, and 1,420 age-matched subjects without gonorrhea were included in the control group. After adjusting for age, comorbidities, urbanization level, hospital level, and monthly income, gonorrhea was significantly associated with an increased risk of prostate cancer (adjusted hazard ratio = 5.66, 95% confidence interval = 1.36-23.52). Men aged 45-70 years and those with lower monthly income were more strongly associated with prostate cancer in the study group than the control group. The higher risk for developing prostate cancer were also found in those without syphilis, without genital warts, without diabetes mellitus, without chronic obstructive pulmonary disease, without benign prostatic hypertrophy, without chronic prostatitis, and without alcoholism. The Kaplan-Meier analysis showed the risk of prostate cancer was significantly higher in the study group than in the control group. Gonorrhea may be involved in the development of prostate cancer. More intensive screening and prevention interventions for prostate cancer should be recommended in men with gonorrhea.

Latest Evidence on the Impact of Smoking, Sports, and Sexual Activity as Modifiable Lifestyle Risk Factors for Prostate Cancer Incidence, Recurrence, and Progression: A Systematic Review of the Literature by the European Association of Urology Section of Oncological Urology (ESOU)

“…However, the data display significant heterogeneity, which limits the validity of conclusions. Two cohort studies have suggested that Neisseria gonorrhoeae infections increase the risk of PCa [95,96]. In one study, HPV detection was more frequent in PCa specimens compared with specimens retrieved from nonmalignant tissue, which was not confirmed by other authors [97,98].…”

“…Experimental studies and in vitro models have shown possible mechanisms linking smoking and PCa progression, such as increased heme-oxygenase-1 messenger RNA expression, which may play a role in tumor angiogenesis [50,64,73,78,79,95]. An effect of smoking on tumor progression through hypermethylation of genes has also been suggested [80,97].…”

The association between epididymo-orchitis and prostate cancer

“…Wang et al conducted a study of 355 men with gonorrhea and 1420 controls and found that gonorrhea resulted in a 5-fold increased risk of PCa. [19] Meanwhile, gonorrhea infection is one of the major causes of epididymo-orchitis. [22] However, the possible mechanisms of PCa and the potential roles of asymptomatic prostatic inflammation and epididymo-orchitis require further investigation.…”

Association of chronic periodontitis with prostatic hyperplasia and prostatitis: A population‐based cohort study in Taiwan

“…The NHIRD uses International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes to record diagnoses. All diagnoses of prostate diseases were made by board‐certified urologists, and all diagnoses of CP given by dentists 10,11 . Bureau of NHI randomly reviews the records of 1 in every 100 ambulatory care visits and 1 in every 20 in‐patient claims to verify the accuracy of the diagnoses (Bureau of National Health Insurance Regulations) 12 .…”