Sexual Factors and the Risk of Prostate Cancer

Abstract

A population-based case-control study of prostate cancer was performed in King County, Washington, in White men and Black men aged 40-64 years, between 1993 and 1996. Incident prostate cancer cases (n = 753) were identified from the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) cancer registry. Controls (n = 703) were identified through random digit dialing and were frequency matched to cases on age. Sexual behavior, medical history, and other potential prostate cancer risk factors were ascertained through an in-person interview. There was no relation between sexual orientation and prostate cancer, although the number of men who had sex with men was small. Risk estimates increased directly with the lifetime number of female sexual partners (trend p < 0.001) but not with male partners (trend p = 0.62). Risk also increased with decreasing age at first intercourse, but this effect disappeared after adjusting for the number of female partners. Prior infection with gonorrhea was positively associated with risk (odds ratio = 1.50; 95% confidence interval: 1.0, 2.2), but no effect was seen among men with other sexually transmitted diseases. No relation between lifetime frequency of sexual intercourse and risk of prostate cancer was apparent. These findings are consistent with previous studies that support an infectious etiology for prostate cancer.

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

“…Our overall null study finding for clinical prostatitis is consistent with findings from eight previous case-control studies of clinical prostatitis and prostate cancer (7,12,15,19,(29)(30)(31)(32) but differs from those from an additional nine casecontrol studies and meta-analysis results (3,8,9,13,17,22,23,28). One methodologic concern for positive studies is detection bias, whereby men with a history of prostatitis may be followed more closely for prostate cancer than men without such a history, due to ongoing investigations for chronic prostatitis or closer medical contact following a diagnosis of prostatitis.…”

“…To our knowledge, no nationally representative estimates of the cumulative incidence of gonorrhea exist. Our null finding for gonorrhea is consistent with the results from eight previous case-control studies (12)(13)(14)(15)(16)(17)(18)(19) but differs from those from an additional six case-control studies and meta-analysis findings (2,7,11,(20)(21)(22)(23). Profound nondifferential misclassification of gonorrhea due to poor recall or a reluctance to report stigmatizing diseases is unlikely to explain our null result for several reasons.…”

“…Additionally, some epidemiologic studies published since the Dennis et al meta-analyses (2, 3) have observed positive findings among STIs, clinical prostatitis, and prostate cancer using nested casecontrol or more rigorous, retrospective case-control study designs, and analytic strategies for assessing detection bias (5)(6)(7)(8)(9). To further investigate STIs, clinical prostatitis, and prostate cancer and to address some of the limitations of previous studies, we conducted a large, prospective investigation of self-reported histories of gonorrhea, syphilis, and clinical prostatitis in relation to subsequent development of prostate cancer.…”

Prostate calculi in cancer and BPH in a cohort of Korean men: presence of calculi did not correlate with cancer risk

“…In another study, Rosenblatt et al [19] found that an insignificant positive correlation existed between prostatitis and PCa if the prostatitis was diagnosed ≤ 2 years before the diagnosis of PCa was made. This finding suggests the possibility of detection bias.…”

Epidemiology of Prostate Cancer

“…44 In studies on factors such as social class, smoking, 45 alcohol consumption, 46 physical 47 and sexual activity, 48 and vasectomy, 49 the summary is that none showed a relationship with risk of prostate cancer, though some studies have shown increase in risk of prostate cancer with an increase in number of sexual partners. 50 There is an increase in odds ratio to 1.57 for prostate cancer in those who had prostatitis. 51,52 …”