Gonorrhea, Syphilis, Clinical Prostatitis, and the Risk of Prostate Cancer

Sutcliffe, Siobhan; Giovannucci, Edward; Marzo, Angelo M. De; Leitzmann, Michael F.; Willett, Walter C.; Platz, Elizabeth A.

doi:10.1158/1055-9965.epi-05-0913

Cited by 83 publications

(83 citation statements)

References 37 publications

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“…Based on participants' lower reported lifetime prevalence of STIs, which we have previously hypothesized also reflects a lower likelihood of repeat and coinfections [32], as well as their education, socio-economic status, and race/ethnicity, we postulated that histories of gonorrhea and syphilis in this cohort likely reflected only one or two episodes of treated infection with a low likelihood of co-infections. Therefore, our findings suggested that low exposure to gonorrhea and syphilis does not increase risk of prostate cancer [55]. These findings were supported by subsequent results in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, in which the authors observed no association for a history of gonorrhea, and an unstable, possibly inverse association for a history of syphilis among Caucasian participants, who had similarly low reported lifetime prevalences of infection as HPFS participants.…”

Section: Information Biassupporting

confidence: 83%

“…However, more prospective studies are now beginning to be conducted. In 2006, we published the results of our prospective cohort investigation in the Health Professionals Follow-up Study (HPFS), in which we observed no association for a history of gonorrhea and an unstable, null association for a history of syphilis and risk of prostate cancer [55]. Based on participants' lower reported lifetime prevalence of STIs, which we have previously hypothesized also reflects a lower likelihood of repeat and coinfections [32], as well as their education, socio-economic status, and race/ethnicity, we postulated that histories of gonorrhea and syphilis in this cohort likely reflected only one or two episodes of treated infection with a low likelihood of co-infections.…”

Section: Information Biasmentioning

confidence: 99%

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Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Sutcliffe

2010

Future Oncol.

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ABSTRACT/SUMMARYSince the early 1950s when sexually transmitted infections (STIs) were first proposed as a possible risk factor for prostate cancer, numerous epidemiologic studies have been conducted.Initially, these studies were primarily small case-control studies with retrospective, self-reported assessment of a narrow range of STIs, typically either any STIs, or gonorrhea and syphilis.However, as new STIs have been discovered/recognized, new and better tests to detect histories of STIs have been developed, and new resources for prostate cancer research have been created, epidemiologic studies have expanded to include a wider range of STIs, and have moved towards more rigorous, prospective study designs and serologic assessment of STI histories. The results of these studies are reviewed and discussed, as well as possible new avenues of research, such asTrichomonas vaginalis infection and infections not typically considered to be sexually transmitted. 3 EARLY HYPOTHESES FOR SEXUALLY TRANSMITTED INFECTIONS AND PROSTATE CANCEREarly hypotheses related to a sexually transmitted etiology of prostate cancer were initially motivated by contemporary, epidemiologic patterns of prostate cancer occurrence. In the early 1950s, Ravich and Ravich [1, 2] noted a higher prostate cancer prevalence among mainly uncircumcised non-Jewish than circumcised Jewish men, similar to patterns for penile cancer and cervical cancer among female partners of these men, leading them to propose that observed patterns might be explained by sexual transmission of a virus or other carcinogenic agent contained within the smegma of uncircumcised males. Subsequent investigators [3][4][5] further proposed additional hypotheses related to infection, sexual behavior, and sexual frustration to explain other contemporary patterns of prostate cancer occurrence by marital, paternal, and racial status. Together, these observations and hypotheses led to a series of investigations beginning in the early 1970s to examine possible associations between STIs and sexual behavior in relation to prostate cancer. Selection of STIs STI markers:Most early investigations of STIs and prostate cancer assessed either a history of any STIs or individual histories of gonorrhea and syphilis as markers or possibly vectors of the potentially causative STI or sexual behavior [6][7][8][9]. These STIs were likely selected because they were the most common, well-known, and symptomatic STIs at the time, making them also more readily assessed by self-report, medical record abstraction, or registry query. Prostate inflammation:Other early studies focused specifically on gonorrhea because it frequently led to 4 secondary gonococcal prostatitis in the pre-and early-antibiotic era, and because prostate inflammation had previously been hypothesized as a cause of atrophy and subsequent prostate cancer ([9-11] and references therein). This inflammation-atrophy-prostate cancer hypothesis has since gained further support with the observation of morphological and epigenetic transitions betwe...

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Section: Information Biassupporting

confidence: 83%

Section: Information Biasmentioning

confidence: 99%

Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses

Sutcliffe

2010

Future Oncol.

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“…Since the latter evidence suggested the existence of a detection bias in the patient population, subsequent subset analyses were performed by considering only men screened for prostate cancer. In this context, a significant association was found between PCa and a history of clinical prostatitis among men diagnosed for PCa <59 years of age (22). In summary, analysis by age revealed significant links that may have been overlooked in studies performed on a non-stratified population.…”

Section: Clinical and Epidemiological Studiesmentioning

confidence: 79%

“…A large prospective study reported in 2006 by Sutcliffe and coworkers, based on data collected in the frame of the Health Professional Follow-up Study, included 5,732 patients with and 29,854 patients without prostatitis (22). Although the study failed to show an overall link between prostatitis and prostate cancer, it demonstrated a positive significant association between these conditions in the younger male population.…”

Section: Clinical and Epidemiological Studiesmentioning

confidence: 99%

Inflammation, prostatitis, proliferative inflammatory atrophy: ‘Fertile ground’ for prostate cancer development?

Perletti¹,

Montanari

Vral³

et al. 2009

Mol Med Rep

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Abstract. Inflammatory processes caused by chemical, physical or biological agents are known to be important cofactors in the pathogenesis of human cancer. In the prostate, epithelial tissue damage followed by cell regeneration in the presence of inflammation is believed to be a key event in neoplastic transformation. According to the 'injury and regeneration' model, inflammatory cells infiltrating the prostate release reactive species in response to bacterial/viral infection, uric acid, or dietary prostate carcinogens. Besides inducing inflammation, tissue injury by these and other agents would promote the appearance of proliferative inflammatory atrophy (PIA). A subset of proliferating atrophic cells -possibly showing stemcell features -may be exposed to the genotoxic insult of free radicals and to an increased rate of mutations and chromosomal aberrations, ultimately leading to neoplastic initiation, promotion and progression. In the last decade, the link between inflammation and cancer and the hypothesis pointing to PIA as a risk lesion for prostate cancer have been extensively investigated at the pre-clinical, clinical, morphological, cellular and molecular levels. In this article, recent reports describing supportive or negative evidence on the link between prostate inflammation, atrophy and cancer are schematically reviewed.

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“…History of prostatitis (OR 25.0, 95% CI 9.2-67.9) was observed to be positively associated with prostate cancer risk (Hosseini et al, 2010). On the other hand many prospective studies have not shown any significant association between history of gonorrhea or syphilis and prostate cancer (Huang et al, 2008;Sutcliffe et al, 2006). In different studies, the frequency of sexual activity has been found to have direct relationship with the development of prostate cancer.…”

Section: Sexual Behavior and Sexually Transmitted Diseasesmentioning

confidence: 99%