Sexual Behavior, Sexually Transmitted Diseases and Prostatitis: The Risk of Prostate Cancer in Black Men

Sarma, Aruna V.; McLaughlin, Julie C.; Wallner, Lauren P.; Dunn, Rodney L.; Cooney, Kathleen A.; Schottenfeld, David; Montie, James E.; Wei, John T.

doi:10.1016/j.juro.2006.04.075

« Previous Next »The Journal of Urology
Volume 176, Issue 3 , Pages 1108-1113, September 2006

Sexual Behavior, Sexually Transmitted Diseases and Prostatitis: The Risk of Prostate Cancer in Black Men

Aruna V. Sarma
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
- Correspondence: Department of Urology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0759 (telephone: 734-763-7514; FAX: 734-936-9536).
Julie C. McLaughlin
- Department of Urology, University of Michigan, Ann Arbor, Michigan
Lauren P. Wallner
- Department of Urology, University of Michigan, Ann Arbor, Michigan
Rodney L. Dunn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
Kathleen A. Cooney
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
David Schottenfeld
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
James E. Montie
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Financial interest and/or other relationship with Fujisawa Healthcare, Wilex, Tengion, Early Detection Research Network of the National Cancer Institute and Cangen Biotechnologies, Inc., Guilford Pharmaceuticals, Astellas and Elsevier.
John T. Wei
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Financial interest and/or other relationship with Sanofi, Laserscope, GTX and Envisioneer.

Received 10 November 2005

Purpose

Black men are diagnosed with prostate cancer more often than white men, present with more advanced disease and have worse stage specific survival. Given the high risk of incidence and mortality in this population, determining potentially modifiable factors is important. Recent studies have suggested a link between chronic inflammation and development of prostate cancer. In concurrence, population based studies of white men have revealed an increased risk of prostate cancer with history of sexually transmitted diseases and prostatitis.

Materials and Methods

We explored the chronic inflammation hypothesis of prostate cancer development among black men by examining sexual activity, sexually transmitted diseases and prostatitis in a population based study of 129 patients and 703 controls 40 to 79 years old.

Results

After adjusting for age, income, cigarette smoking, and history of digital rectal examination and prostate specific antigen tests in the last 5 years, we observed that a history of gonorrhea infection and prostatitis increased the odds of prostate cancer 1.78-fold (95% CI 1.13, 2.79) and 4.93-fold (95% CI 2.79, 8.74), respectively. Men reporting 25 or more sexual partners were 2.80 (95% CI 1.29, 6.09) times more likely to be diagnosed with cancer compared to men with 5 or fewer partners.

Conclusions

Our findings support the significance of prior sexual practices, exposure to sexually transmitted microbial agents and history of prostatic infection in the natural history of prostate cancer in black men. Additional prospective research incorporating serological markers of infectious agents or predictive markers of chronic inflammation should serve to elucidate the possible causal pathway of recurring or persistent infection in the etiology of prostate cancer in black men.

Key Words: sexually transmitted diseases , African Americans , prostatic neoplasms

Abbreviations and Acronyms: BMI, body mass index , DRE, digital rectal examination , HPV, human papilloma virus , PSA, prostate specific antigen , STD, sexually transmitted disease