Sexually Transmissible Infections and Prostate Cancer Risk

Abstract

Background: Sexually transmissible infections (STI) have been variably associated with increased risks of prostate cancer, largely in case-control studies. Methods: In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, we examined risk of prostate cancer in relation to serum antibodies to Chlamydia trachomatis, human papillomavirus-16 and -18, herpes simplex virus-2, cytomegalovirus, and human herpesvirus-8 in 868 cases (765 Whites and 103 Blacks) and 1,283 controls matched by race, age, time since initial screening, and year of blood draw; all blood samples were collected at least 1 year before prostate cancer diagnosis, except for 43 Black cases. We also assessed risk associated with self-reported history of syphilis and gonorrhea. Results: Prevalences of the 7 STIs among controls were weakly correlated, and all were more frequent among

Epidemiology of Prostate Cancer

“…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.…”

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

“…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. Null or generally unstable results were also observed, however, among African-American participants in the PLCO Cancer Screening Trial [56] and among Caucasian and African-American participants in the subsequent California Men's Health Study [57], all of whom had considerably higher reported lifetime prevalences of gonorrhea and syphilis than HPFS or Caucasian PLCO participants. Therefore, these findings suggest that any exposure to gonorrhea or syphilis, even more extensive exposure, at least as experienced in the U.S. in the current antibiotic era, does not increase risk of prostate cancer.…”

“…Initially, studies 17 of HHV-8 infection and prostate cancer observed null associations [81,82] or detected no evidence of HHV-8 infection when comparing cancerous to benign prostate tissue [83,84] ( Table 5) [56,58,86,87], leading the authors of the first positive study to propose that discrepancies between these null/inverse findings and their positive findings might be due to chance or possibly to an unknown environmental or genetic difference between Tobagan men and men from other study countries, as their positive association has reportedly remained significant after analysis of additional specimens from Tobago [87]. Therefore, more targeted investigations may be necessary to disentangle these two possibilities, and to explore a possible inverse association between HHV-8 infection and prostate cancer.…”

“…However, despite use of these new, improved assays, most later studies of HSV-2 [56,73,86,88], CMV [56,88] and EBV seropositivity [88] have observed null or generally unstable associations with prostate cancer (Table 5). One exception to this statement is the recently observed positive association between HSV-2 seropositivity and prostate cancer risk in a U.S. military study using serum specimens collected a mean of 94 months before diagnosis, but not using specimens collected a mean of 10 months before diagnosis [73].…”

“…Initially, this STI was included in investigations of prostate cancer risk as a marker of sexual activity [63]; however, it has since been investigated in relation to prostate cancer in its own right because of its known ability to cause chronic, persistent infections, and asymptomatic and symptomatic prostate inflammation in some men [ [56,58,89] and references therein]. Despite this promising rationale, most studies to date have observed generally null or occasionally inverse associations between a history of chlamydia and prostate cancer, irrespective of the study design, method of assessment (serology or self-report), type of C. trachomatis antibody assay used (enzyme immunoassay or micro-immunofluorescence assay), and timing of specimen collection if assessed by serology [42, 56-58, 63, 73, 89] (Table 5).…”