title: Sexually transmitted infections and prostate cancer risk: a systematic review and meta-analysis.
abstract: Prostate cancer (PC) is the second most incident cancer and the sixth cause of death by cancer in men worldwide. Despite extensive research efforts, no modifiable risk factors have been consistently identified for PC risk. A number of studies have focused on possible relationships between sexually transmitted infections (STIs) and PC. We performed a meta-analysis to explore the association between infection caused by Neisseria gonorrheae, Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Herpes Simplex Virus types 1 and 2, Human Herpes Virus 8 and Cytomegalovirus, and PC. We conducted a comprehensive, systematic bibliographic search of medical literature to identify relevant studies. We calculated summary relative risk (SRR) and 95% confidence intervals (CI) for the association between each STI and PC through random effect models. Subgroup, meta-regression and sensitivity analyses were carried out to detect between-study heterogeneity and bias. We included 47 studies published between 1971 and 2011. Men who reported having ever had any STI in lifetime had an increased PC (SRR 1.49, 95% CI 1.19-1.92). We found a significantly increased PC risk in men having had gonorrhoea (SRR 1.20, 95% CI 1.05-1.37). No other single STI was significantly associated with PC. Due to high incidence of both STIs and PC worldwide, prevention of STIs may help preventing a considerable number of PC cases.
authors.affiliation: Unit of Molecular and Nutritional Epidemiology, Institute for Cancer Research and Prevention (ISPO), Italy. Electronic address: saverio.caini@gmail.com.
authors.forename: Saverio
authors.initials: S
authors.lastname: Caini
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
authors.affiliation: Department of Infectious Disease Epidemiology, National Center for Epidemiology, Budapest, Hungary.
authors.forename: Maria
authors.initials: M
authors.lastname: Dudas
authors.affiliation: Division for HIV/AIDS, STI and Blood-Borne Infections, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Viviane
authors.initials: V
authors.lastname: Bremer
authors.affiliation: South East Regional Epidemiology Unit, Health Protection Agency, London, UK.
authors.forename: Ettore
authors.initials: E
authors.lastname: Severi
authors.affiliation: Swedish Institute for Communicable Disease Control, Solna, Sweden.
authors.forename: Alin
authors.initials: A
authors.lastname: Gherasim
mesh_terms: D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications*
keywords: Gonorrhoea; Meta-analysis; Prostate cancer; Review; Sexually transmitted diseases