title: Gonorrhea, syphilis, clinical prostatitis, and the risk of prostate cancer.
abstract: BACKGROUND
  Although previous case-control studies have observed positive associations among gonorrhea, syphilis, clinical prostatitis, and prostate cancer, many may have been susceptible to recall and interviewer biases due to their retrospective designs. Therefore, to investigate these associations without concerns of recall and interviewer biases, we conducted a large, prospective investigation in the Health Professionals Follow-up Study.
  
  
  METHODS
  In 1992, participants were asked to report their histories of gonorrhea, syphilis, and clinical prostatitis by mailed questionnaire. Prostate cancer diagnoses were ascertained by self-report on the 1994 and each subsequent biennial follow-up questionnaire and confirmed by medical record review.
  
  
  RESULTS
  Of the 36,033 participants in this analysis, 2,263 were diagnosed with prostate cancer between the date of return of the 1992 questionnaire and 2002. No association was observed between gonorrhea [adjusted relative risk (RR), 1.04; 95% confidence interval (95% CI), 0.79-1.36] or syphilis (RR, 1.06; 95% CI, 0.44-2.59) and prostate cancer. Overall null results were also observed between clinical prostatitis and prostate cancer (RR, 1.08; 95% CI, 0.96-1.20), although a significant positive association was observed among younger men (<59 years) screened for prostate cancer (RR, 1.49; 95% CI, 1.08-2.06; P(interaction) = 0.006).
  
  
  CONCLUSIONS
  Gonorrhea and syphilis do not seem to be risk factors for prostate cancer in this cohort of men with a lower burden of sexually transmitted infections. Clinical prostatitis is also unlikely to be a risk factor, although possible roles for prostatitis in younger men and asymptomatic prostatic infection and inflammation cannot be ruled out.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6138, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Sutcliffe
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Angelo M
authors.initials: AM
authors.lastname: De Marzo
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D011472:Prostatitis / Q000150:complications*; D012306:Risk; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000150:complications*