Trichomonas vaginalis infection and risk of prostate cancer: associations by disease aggressiveness and race/ethnicity in the PLCO Trial

Abstract

Purpose Results from previous sero-epidemiologic studies of Trichomonas vaginalis infection and prostate cancer (PCa) support a positive association between this sexually transmitted infection and aggressive PCa. However, findings from previous studies are not entirely consistent, and only one has investigated the possible relation between T. vaginalis seropositivity and PCa in African-American men who are at highest risk of both infection and PCa. Therefore, we examined this possible relation in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, including separate analyses for aggressive PCa and African-American men. Methods We included a sample of participants from a previous nested case-control study of PCa, as well as all additional Caucasian, aggressive and African-American cases diagnosed since the previous study (total n=438 Gleason 7 Caucasian cases, 487 more advanced Caucasian cases (≥Gleason 8 or stage III/IV), 201 African-American cases, and 1,216 controls). We tested baseline sera for T. vaginalis antibodies. Results No associations were observed for risk of Gleason 7 (odds ratio (OR)=0.87, 95% confidence interval (CI)=0.55–1.37) or more advanced (OR=0.90, 95% CI=0.58–1.38) PCa in Caucasian men, or for risk of any PCa (OR=1.06, 95% CI=0.67–1.68) in African-American men. Conclusions Our findings do not support an association between T. vaginalis infection and PCa.

Trichomonas vaginalis infection and prostate‐specific antigen concentration: Insights into prostate involvement and prostate disease risk

“…Lastly, if we view our findings in the context of prostate disease development rather than prostate involvement, our nonsignificant findings are in line with those from a growing body of studies that observed null associations between T. vaginalis serostatus and prostate cancer risk and aggressiveness in older men, as well as those from one, but not the other, previous study of T. vaginalis serology and BPH. However, our findings are not consistent with the high prevalence of T. vaginalis DNA and antigens observed in prostate tissue from older men with BPH …”

“…Viewing our findings in the context of the longer‐term or cumulative influences of current and/or resolved infections rather than the acute influences of infection, our nonsignificant findings are consistent with those from previous cross‐sectional studies of nonlifelong infections ( T. vaginalis and syphilis) that observed null associations with PSA, but differ from those from other cross‐sectional and longitudinal studies that observed positive findings for C. trachomatis serostatus and histories of medical record–confirmed chlamydia and NCNGU diagnoses with PSA concentration and trajectories in younger men . However, in the latter study, positive associations were observed only when PSA trajectories were examined and not when only one PSA measurement was used (% with PSA ≥0.7 ng/mL = 38.3 for chlamydia, 39.6 for gonorrhea, and 31.7 for NCNGU vs 37.1 for controls without these infections; P = 0.772, 0.639, and 0.659, respectively).…”

“…Possible mechanisms by which it may contribute to these conditions include: (a) adherence to and lysis of prostate epithelial cells; (b) induction of intra‐prostatic inflammation and cytokine production; (c) inhibition of prostate epithelial cell apoptosis; and (d) upregulation of proto‐oncogenes . More recently, T. vaginalis has also been observed to increase prostate cell line proliferation and invasiveness, has been detected in prostate tissue from men with BPH, and has been found to be associated with the presence of BPH, as well as later prostate cancer risk and aggressiveness in some, but not all, sero‐epidemiologic studies.…”

Investigation of the Secretory Pathway in Trichomonas vaginalis Argues against a Moonlighting Function of Hydrogenosomal Enzymes

“…In males, trichomoniasis is mostly asymptomatic; however, it is associated with a higher risk of aggressive prostate cancer (Marous et al. ).…”

“…Moreover, the infection is associated with a higher risk of HIV transmission, cervical cancer, and preterm birth and higher rates of mortality in newborn babies (Dionne-Odom et al 2018;Feng et al 2018;Nanda et al 2006;Petrin et al 1998;Rendon-Maldonado et al 2003). In males, trichomoniasis is mostly asymptomatic; however, it is associated with a higher risk of aggressive prostate cancer (Marous et al 2017).…”