title: Sexual behavior, sexually transmitted diseases and prostatitis: the risk of prostate cancer in black men.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Urology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0330, USA. asarma@umich.edu
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Sarma
authors.forename: Julie C
authors.initials: JC
authors.lastname: McLaughlin
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Wallner
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Dunn
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Cooney
authors.forename: David
authors.initials: D
authors.lastname: Schottenfeld
authors.forename: James E
authors.initials: JE
authors.lastname: Montie
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications* / Q000453:epidemiology*; D011472:Prostatitis / Q000150:complications* / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications* / Q000453:epidemiology*