title: Lower Urinary Tract Infection and Subsequent Risk of Prostate Cancer: A Nationwide Population-Based Cohort Study.
abstract: OBJECTIVE
  We investigated whether lower urinary tract infection (LUTI), including cystitis or urethritis, is associated with an increased risk of developing prostate cancer (PCa), in a nationwide population-based cohort study.
  
  
  METHODS
  We identified 14,273 men newly diagnosed with LUTI (9347 with cystitis, and 4926 with urethritis) between 1998 and 2011, from the Taiwan Longitudinal Health Insurance Database 2000. Each patient was randomly frequency-matched with 4 men without LUTI, based on age and index year of diagnosis. Cox's proportional hazard regression analysis was performed to estimate the effect of LUTI on the PCa risk.
  
  
  RESULTS
  The risk of developing PCa was significantly higher in the cystitis cohort (adjusted HR = 1.46, 95% CI = 1.20-1.78) and in the urethritis cohort (adjusted HR = 1.72, 95% CI = 1.26-2.34) than in the group without LUTI. Further analyses indicated that patients with more than 5 medical visits for LUTI per year had a significantly greater risk of developing PCa.
  
  
  CONCLUSIONS
  We found that cystitis or urethritis may play an etiological role in the development of PCa in Taiwanese men, particularly in those with repeated medical visits for cystitis or urethritis. Further studies are warranted on the association between LUTI and PCa in other countries, particularly where the prevalence of PCa is high.
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chao-Yueh
authors.initials: CY
authors.lastname: Fan
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wen-Yen
authors.initials: WY
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kuen-Tze
authors.initials: KT
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chun-Shu
authors.initials: CS
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Hsing-Lung
authors.initials: HL
authors.lastname: Chao
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Jen-Fu
authors.initials: JF
authors.lastname: Yang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.|Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
authors.forename: Chia-Hung
authors.identifier: http://orcid.org/0000-0002-6368-3676
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003556:Cystitis / Q000150:complications*; D016208:Databases, Factual; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014526:Urethritis; D014552:Urinary Tract Infections / Q000150:complications / Q000453:epidemiology*