Abstract
A population-based case-control study was carried out among 981 men (479 black, 502 white) with pathologically confirmed prostate cancer and 1315 controls (594 black, 721 white). In-person interviews elicited information on sexual behaviour and other potential risk factors for prostate cancer. Blood was drawn for serologic studies in a subset of the cases (n = 276) and controls (n = 295). Prostate cancer risk was increased among men who reported a history of gonorrhoea or syphilis (odds ratio (OR) = 1.6; 95% confidence internal (CI) 1.2–2.1) or showed serological evidence of syphilis (MHA-TP) (OR = 1.8; 95% CI 1.0–3.5). Patterns of risk for gonorrhoea and syphilis were similar for blacks (OR = 1.7; 95% CI 1.2–2.2) and whites (OR = 1.6; 95% CI 0.8–3.2). Risks increased with increasing occurrences of gonorrhoea, rising to OR = 3.3 (95% CI 1.4–7.8) among subjects with three or more events (P trend= 0.0005). Frequent sexual encounters with prostitutes and failure to use condoms were also associated with increased risk. Syphilis, gonorrhoea, sex with prostitutes and unprotected sexual intercourse may be indicators of contact with a sexually transmissible factor that increases the risk of prostate cancer. © 2000 Cancer Research Campaign
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References
Anderson JE, McCormick L and Fichtner R (1994) Factors associated with self-reported STDs – data from a national survey. Sexually Trans Dis 21: 303–308
Anderson S-O, Baron J, Bergstrom R, Lindgren C, Wolk A and Adami H-A (1996) Lifestyle factors and prostate cancer risk: a case–control study in Sweden. Cancer Epidemiol Biomarkers Prev 5: 509–513
Bagatell CJ and Bremmer WJ (1997) Androgens and behavior in men and women. Endocrinologist 7: 97–102
Baker LH, Mebwust WK, Chin TDY, Chapman AL, Hinthorn D and Towle D (1981) The relationship of Herpesvirus to carcinoma of the prostate. J Urol 125: 370–374
Breslow NE and Day NE (1980) Statistical Methods in Cancer Research. Volume 1. The Analysis of Case–Control Studies. International Association for Cancer Research: Lyon, France
Brunham RC and Plummer FA (1990) A general model of sexually transmitted disease epidemiology and its implication for control. Med Clin N Am 74: 1339–1352
Buena F, Swerdloff RS, Steiner BS, Lutchmansingh P, Peterson MA, Pandian MR, Galmarini M and Bhasin S (1993) Sexual function does not change when serum testosterone levels are pharmacologically varied within the normal-male range. Fertil Steril 59: 1118–1123
Carter JJ, Koutsky LA, Wipf GC, Christensen ND, Lee S-K, Kuypers J, Kiviat N and Galloway DA (1996) The natural history of human papillomavirus type 16 capsid antibodies among a cohort of university women. J Infect Dis 174: 927–936
Cuzick J (1995) Human papillomavirus infection of the prostate. Cancer Surveys 23: 91–95
Devesa SS, Grauman DJ, Blot WJ, Pennello G, Hoover RN and Fraumeni JF Jr (1999) Atlas of Cancer Mortality in the United States, 1950–94. U.S. Department of Health and Human Services: Rockville, MD
Dillner J, Knekt P, Boman J, Lehtinen M, Af Geijersstam V, Sapp M, Schiller J, Maatela J and Aromaa A (1998) Sero-epidemiological association between human-papillomavirus infection and risk of prostate cancer. Int J Cancer 75: 564–567
Division of STD Prevention (1997) Sexually Transmitted Disease Surveillance, 1996. Centers for Disease Control and Prevention: Atlanta, GA
Feminella JJ and Lattimer JR (1974) An apparent increase in genital carcinoma among wives of men with prostatic cancer: an epidemiologic survey. Pirquet Bull Clin Med 20: 3–9
Green LW (1970) Manual for scoring socioeconomic status for research on health behavior. Publ Health Rep 85: 815–827
Haas J, Bolan G, Larsen SA, Clement M, Bacchetti P and Moss A (1990) Sensitivity of treponemal tests for detecting prior treated syphilis during human immunodeficiency virus infection. J Infect Dis 162: 862–866
Hayes RB, Pottern LM, Greenberg R, Schoenberg J, Swanson MG, Liff J, Schwartz AG, Brown LM and Hoover RN (1993) Vasectomy and prostate cancer in US blacks and whites. Am J Epidemiol 137: 263–269
Hayes RB, Pottern LM, Swanson GM, Liff J, Schoenberg J, Greenberg R, Schwartz AG and Hoover RN (1994) Tobacco use and prostate cancer in U.S. blacks and whites. Cancer Causes Control 5: 221–226
Hayes RB, Liff JM, Pottern LM, Greenberg RS, Schoenberg JB, Schwartz AG, Swanson GM, Silverman DT, Brown LM, Hoover RN and Fraumeni JF Jr (1995) Prostate cancer risk in U.S. blacks and whites with a family history of prostate cancer. Int J Cancer 60: 361–364
Hayes RB, Brown LM, Schoenberg JB, Greenberg RS, Silverman DT, Schwartz AG, Swanson GM, Benichou J, Liff JM, Hoover RN and Pottern L (1997) Alcohol use and prostate cancer risk in U.S. blacks and whites. Am J Epidemiol 143: 692–697
Hayes RB, Ziegler R, Gridley G, Greenberg RS, Swanson GM, Schoenberg JB, Silverman DT, Brown LM, Schwartz AG, Fraumeni JF Jr and Hoover RN (1999) Dietary animal fat and differential risks for prostate cancer among U.S. blacks and whites. Cancer Epidemiol Biomarkers Prev 8: 25–34
Heshmat MY, Kovi J, Herson J, Jones GW and Jackson MA (1975) Epidemiologic association between gonorrhea and prostatic carcinoma. Urology 6: 457–460
Honda GD, Bernstein L, Ross RK, Greenland S, Gerkins V and Henderson BE (1988) Vasectomy, cigarette smoking, and age at first sexual intercourse as risk factors for prostate cancer in middle-aged men. Br J Cancer 57: 326–331
IARC (1995) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 64. Human Papillomaviruses. Lyon, France: International Agency for Research on Cancer
Jackson MA, Kovi J, Heshmat MY, Ogunmuyiwa TA, Jones GW, Williams AO, Christian EC, Nkposong EO, Rao MS, Jackson AG and Ahluwalia BS (1980) Characterization of prostatic cancer among blacks: a comparison between a low-incidence area, Ibadan, Nigeria, and a high-incidence area, Washington, DC. Prostate 1: 185–205
Kennedy EJ Jr (1990) Microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). In: A Manual of Tests for Syphilis, Larsen SA, Hunter EF, Kraus SJ (eds), pp. 153–166. American Public Health Association: Washington, DC
Kilmarx PH, Zaidi AA, Thomas JC, Nakashima AK, St Louis ME, Flock ML and Peterman TA (1997) Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis. Am J Publ Health 87: 1937–1943
Koopman JS and Longini IM Jr (1994) The ecological effects of individual exposures and nonlinear disease dynamics in populations. Am J Publ Health 84: 836–842
Krain LS (1974) Some epidemiologic variables in prostatic carcinoma in California. Prev Med 3: 154–159
La Vecchia C, Franceschi S, Talamini R, Negri E, Boyle P and D'Avanzo B (1993) Marital status, indicators of sexual activity and prostatic cancer. J Epidemiol Community Health 47: 450–453
Lees REM, Steele R and Wardle D (1985) Arsenic, syphilis, and cancer of the prostate. J Epidemiol Commun Med 39: 227–230
Mandel JS and Schuman LM (1987) Sexual factors and prostatic cancer: results from a case–control study. J Gerontol 42: 259–264
Mantzoros CS, Georgiadis EI and Trichopoulus D (1995) Contribution of dihydrotestosterone to male sexual behavior. Br Med J 310: 1289–1291
Mishina T, Watanabe H, Araki H and Nakao M (1985) Epidemiological study of prostate cancer by matched-pair analysis. Prostate 6: 423–436
Nakashima AK, Rolfs RT, Flock ML, Kilmarx P and Greenspan JR (1996) Epidemiology of syphilis in the United States, 1941–1993. Sexually Trans Dis 23: 16–23
National Cancer Institute (1997) SEER Cancer Statistics Review, 1973–1994. NIH Publication No. 97–2789
Nomura AMY and Kolonel LN (1991) Prostate cancer: a current perspective. Epidemiol Rev 13: 200–227
Pienta KJ and Esper PS (1993) Risk factors for prostate cancer. Ann Intern Med 118: 793–803
Romanowski B, Sutherland R, Fick GH, Mooney D and Love EJ (1991) Serologic response to treatment of infectious syphilis. Ann Intern Med 114: 1005–1009
Ross RK and Schottenfeld D (1996) Prostate cancer. In: Cancer Epidemiology and Prevention, Schottenfeld D, Fraumeni JF Jr. (eds), pp. 1180–1206. Oxford University Press: New York
Ross RK, Shimizu H, Paganini-Hill A, Honda G and Henderson BE (1987) Case– control studies of prostatic cancer in blacks and whites in Southern California. J Natl Cancer Inst 78: 869–874
Rotkin ID (1977) Studies in epidemiology of prostatic cancer. Cancer Treat Rep 61: 173–180
Schiffman MH, Bauer HM, Hoover RN, Glass AG, Cadell DM, Rush BB, Scott DR, Sherman ME, Kurman RJ, Wacholder S, Stanton CK and Manos MM (1993) Epidemiologic evidence showing that human papillomavirus infection causes most cervical intraepithelial neoplasia. J Natl Cancer Inst 85: 958–964
Schiffman MH, Brinton LA, Devesa SS and Fraumeni JF Jr (1996) Cervical cancer. In: Cancer Epidemiology and Prevention, Schottenfeld D, Fraumeni JF Jr. (eds), pp. 1090–1116. Oxford University Press: New York
Staskus KA, Zhong W, Gebhard K, Herndier B, Wang H, Renne R, Beneke J, Pudney J, Anderson DJ, Ganem D and Haase AT (1997) Kaposi's sarcoma-associated herpesvirus gene expression in endothelial (spindle) tumor cells. J Virol 71: 715–719
Steele R, Lees REM, Kraus AS and Rao C (1971) Sexual factors in the epidemiology of the prostate. J Chron Dis 24: 29–37
Strickler HD, Hildesheim A, Viscidi RP, Shah KV, Goebel B, Drummond J, Waters D, Sun Y, Hubbert NL, Wacholder S, Brinton LA, Han C-L, Nasca PC, McLimins R, Turk K, Devairakkam V, Leitman S, Martin C and Schiller JT (1997) Interlaboratory agreement among results of human papillomavirus type 16 enzyme-linked immunosorbent assays. J Clin Microbiol 35: 1751–1756
Strickler HD, Burk R, Shah K, Viscidi R, Jackson A, Pizza G, Bertoni F, Schiller JT, Manns A, Metcalf R, Qu W and Goedert JJ (1998) A multifaceted study of human papillomavirus and prostate carcinoma. Cancer 82: 1118–1125
Strickler HD, Kirk GD, Figuero P, Ward E, Braithwaite AR, Ecoffery C, Drummond J, Goebbel B, Waters D, McLimens R and Manns A (1999) HPV 16 antibody prevalence in Jamaica and the United States reflects differences in cervical cancer rates. Int J Cancer
Thomas JC, Schoenbach VJ, Weiner DH, Parker EA and Earp JA (1996) Rural gonorrhea in the southeastern United States: a neglected epidemic?. Amer J Epidemiol 143: 269–277
Waksberg J (1978) Sampling methods for random digit dialing. J Am Stat Assoc 73: 40–46
Wynder EL, Mabuchi K and Whitmore WF (1971) Epidemiology of cancer of the prostate. Cancer 28: 344–360
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Hayes, R., Pottern, L., Strickler, H. et al. Sexual behaviour, STDs and risks for prostate cancer. Br J Cancer 82, 718–725 (2000). https://doi.org/10.1054/bjoc.1999.0986
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DOI: https://doi.org/10.1054/bjoc.1999.0986
