title: Gonorrhea infection increases the risk of prostate cancer in Asian population: a nationwide population-based cohort study.
abstract: This nationwide population-based retrospective cohort study evaluated the risk of developing prostate cancer among patients with gonorrhea. We identified cases of newly diagnosed gonorrhea in men between 2000 and 2010 from the Taiwan National Health Insurance Research Database. Each patient with gonorrhea was matched to four controls, based on age and index year. All subjects were followed up from the index date to December 31, 2010. The Cox proportional hazards regression model was used to assess the risk of prostate cancer. A total of 355 men were included in the study group, and 1,420 age-matched subjects without gonorrhea were included in the control group. After adjusting for age, comorbidities, urbanization level, hospital level, and monthly income, gonorrhea was significantly associated with an increased risk of prostate cancer (adjusted hazard ratio = 5.66, 95% confidence interval = 1.36-23.52). Men aged 45-70 years and those with lower monthly income were more strongly associated with prostate cancer in the study group than the control group. The higher risk for developing prostate cancer were also found in those without syphilis, without genital warts, without diabetes mellitus, without chronic obstructive pulmonary disease, without benign prostatic hypertrophy, without chronic prostatitis, and without alcoholism. The Kaplan-Meier analysis showed the risk of prostate cancer was significantly higher in the study group than in the control group. Gonorrhea may be involved in the development of prostate cancer. More intensive screening and prevention interventions for prostate cancer should be recommended in men with gonorrhea.
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan.|Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, No. 155, Sec.2, Linong Street, Taipei City, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Wang
authors.affiliation: School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu District, Taipei City, Taiwan.|Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), No. 161, Sec. 6, Minquan E. Rd., Neihu District, Taipei City, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan.|Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei City, Taiwan.
authors.forename: J-H
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu District, Taipei City, Taiwan.
authors.forename: M-H
authors.initials: MH
authors.lastname: Chiang
authors.affiliation: Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan.|Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, No. 131, Jiankang Rd., Songshan District, Taipei City, Taiwan.
authors.lastname: Ti-Yin
authors.affiliation: Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Tsao
authors.affiliation: School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu District, Taipei City, Taiwan.
authors.forename: F-H
authors.initials: FH
authors.lastname: Lin
authors.affiliation: School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu District, Taipei City, Taiwan. chienwu@mail.ndmctsgh.edu.tw.|Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan. chienwu@mail.ndmctsgh.edu.tw.
authors.forename: W-C
authors.initials: WC
authors.lastname: Chien
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan. shihta.shang@msa.hinet.net.|Department of Internal Medicine, Armed Forces Taoyuan General Hospital, No. 168, Chong Shin Road, Lungtan District, Taoyuan City, Taiwan. shihta.shang@msa.hinet.net.
authors.forename: S-T
authors.initials: ST
authors.lastname: Shang
authors.affiliation: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City, Taiwan.
authors.forename: F-Y
authors.initials: FY
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D016022:Case-Control Studies; D005500:Follow-Up Studies; D006069:Gonorrhea / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult