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Di H, Wen Y, Wang J, Wang J, Wang Y, Li Y, Sun F. The impact of obesity and sexual behavior on prostate cancer risk is mediated by testosterone levels: a mendelian randomization study and mediation analysis. Prostate Int 2024; 12:96-103. [PMID: 39036754 PMCID: PMC11255935 DOI: 10.1016/j.prnil.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 07/23/2024] Open
Abstract
Background The relationship between obesity, sexual behavior, and prostate cancer (PCa) has been widely debated, contributing to a lack of understanding of its potential mechanisms and hindering the development of effective prevention measures. Purpose The aim of this study was to examine the causal effect of body mass index (BMI), age at first sexual intercourse (AFS), and bioavailable testosterone levels on PCa while also quantifying the potential roles of mediators. Method We conducted a Mendelian randomization (MR) study using summary statistics from genome-wide associations of BMI (152,893 European males), AFS (182,791 European males), bioavailable testosterone (184,205 European males), and PCa (79,148 cases, 61,106 controls, European ancestry). Inverse-variance weighted method, weighted median method, MR-Egger regression, Least Absolute Shrinkage and Selection Operator (LASSO), and outlier test were used for MR analyses. Reverse MR and mediation analysis were performed. Data analyses were conducted from December 2022 to July 2023. Results The results showed that genetic liability to BMI was protective of PCa (OR, 0.82; 95% CI: 0.74-0.91; P = 3.29 × 10-4). Genetic liability to later AFS (OR, 1.28; 95% CI: 1.08-1.53; P = 5.64 × 10-3) and higher bioavailable testosterone levels (OR = 1.11, 95% CI: 1.01-1.24, P = 0.04) were associated with an increased risk of PCa. All of these potential causal effects could only be forwarded and were not affected by prostate specific antigen (PSA) screening. After controlling for bioavailable testosterone levels, the causal impact of BMI and AFS on PCa was no longer significant. The mediation analysis suggested that the causal influence of AFS/BMI on PCa relied on bioavailable testosterone levels. Conclusion In conclusion, the difference between the univariable and multivariable MR results suggested that the causal influence of BMI and AFS on PCa relied on bioavailable testosterone levels. Further work is needed to identify other risk factors and to elucidate the specific mechanisms that underlie this causal pathway.
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Affiliation(s)
- Huajie Di
- Department of Pediatrics, The Second Clinical Medical School Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Yi Wen
- Department of Pediatrics, The Second Clinical Medical School Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Junyan Wang
- Department of Pediatrics, The Second Clinical Medical School Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Jiayu Wang
- Department of Pediatrics, The Second Clinical Medical School Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Yeqing Wang
- Electronic Information and Engineering College, Hebei University, Baoding, China
| | - Yuan Li
- Department of Pediatric Urology, Xuzhou Children's Hospital Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Fanghao Sun
- Department of Urology, Xuzhou First People's Hospital, Xuzhou, China
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Lawson JS, Glenn WK. Multiple pathogens and prostate cancer. Infect Agent Cancer 2022; 17:23. [PMID: 35637508 PMCID: PMC9150368 DOI: 10.1186/s13027-022-00427-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/18/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim of this review is to consider whether multiple pathogens have roles in prostate cancer. METHODS We have reviewed case control studies in which infectious pathogens in prostate cancer were compared to normal and benign prostate tissues. We also reviewed additional evidence from relevant published articles. RESULTS We confirmed that high risk human papilloma viruses are a probable cause of prostate cancer. We judged Escherichia coli, Cutibacterium acnes, Neisseria gonorrhoea, Herpes simplex, Epstein Barr virus and Mycoplasmas as each having possible but unproven roles in chronic prostatic inflammation and prostate cancer. We judged Cytomegalovirus, Chlamydia trachomatis, Trichomonas vaginalis and the Polyoma viruses as possible but unlikely to have a role in prostate cancer. CONCLUSIONS AND ACTIONS The most influential cause of prostate cancer appears to be infection induced chronic inflammation. Given the high prevalence of prostate cancer it is important for action to can be taken without waiting for additional conclusive evidence. These include: 1. Encouragement of all boys (as well as girls) to have HPV vaccines 2. The vigorous use of antibiotics to treat all bacterial pathogens identified in the urogenital tract 3. The use of antiviral medications to control herpes infections 4. Education about safe sexual practices.
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Affiliation(s)
- James S. Lawson
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, 2052 Australia
| | - Wendy K. Glenn
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, 2052 Australia
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3
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Association between vasectomy and risk of prostate cancer: a meta-analysis. Prostate Cancer Prostatic Dis 2021; 24:962-975. [PMID: 33927357 DOI: 10.1038/s41391-021-00368-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/12/2021] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND The debate over the association between vasectomy and prostate cancer has been lasted about 40 years and there is no sign of stopping. In the present study, we aimed to evaluate whether vasectomy is associated with prostate cancer based on the most comprehensive and up-to-date evidence available. METHODS The PubMed, Cochrane Library, and EMBASE databases were systematically searched inception to March 14, 2021 without year or language restriction. Multivariable adjusted risk ratios (RRs) were used to assess each endpoint. Risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS A total of 58 studies involving 16,989,237 participants fulfilled inclusion criteria. There was significant association of vasectomy with risk of any prostate cancer (risk ratio, 1.18, 95% CI, 1.07-1.31). Association between vasectomy and advanced prostate cancer (risk ratio, 1.06, 95% CI, 1.01-1.12), low-grade prostate cancer (risk ratio, 1.06, 95% CI, 1.02-1.10), and intermediate-grade prostate cancer (risk ratio, 1.12, 95% CI, 1.03-1.22) were significant. There was no significant association between vasectomy and prostate cancer-specific mortality (risk ratio, 1.01, 95% CI, 0.93-1.10). CONCLUSIONS This study found that vasectomy was associated with the risk of any prostate cancer and advanced prostate cancer. From the current evidence, patients should be fully informed of the risk of prostate cancer before vasectomy.
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Kawahara T, Teramoto Y, Li Y, Ishiguro H, Gordetsky J, Yang Z, Miyamoto H. Impact of Vasectomy on the Development and Progression of Prostate Cancer: Preclinical Evidence. Cancers (Basel) 2020; 12:E2295. [PMID: 32824199 PMCID: PMC7464827 DOI: 10.3390/cancers12082295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
Some observational studies have implied a link between vasectomy and an elevated risk of prostate cancer. We investigated the impact of vasectomy on prostate cancer outgrowth, mainly using preclinical models. Neoplastic changes in the prostate were compared in transgenic TRAMP mice that underwent vasectomy vs. sham surgery performed at 4 weeks of age. One of the molecules identified by DNA microarray (i.e., ZKSCAN3) was then assessed in radical prostatectomy specimens and human prostate cancer lines. At 24 weeks, gross tumor (p = 0.089) and poorly differentiated adenocarcinoma (p = 0.036) occurred more often in vasectomized mice. Vasectomy significantly induced ZKSCAN3 expression in prostate tissues from C57BL/6 mice and prostate cancers from TRAMP mice. Immunohistochemistry showed increased ZKSCAN3 expression in adenocarcinoma vs. prostatic intraepithelial neoplasia (PIN), PIN vs. non-neoplastic prostate, Grade Group ≥3 vs. ≤2 tumors, pT3 vs. pT2 tumors, pN1 vs. pN0 tumors, and prostate cancer from patients with a history of vasectomy. Additionally, strong (2+/3+) ZKSCAN3 expression (p = 0.002), as an independent prognosticator, or vasectomy (p = 0.072) was associated with the risk of tumor recurrence. In prostate cancer lines, ZKSCAN3 silencing resulted in significant decreases in cell proliferation/migration/invasion. These findings suggest that there might be an association between vasectomy and the development and progression of prostate cancer, with up-regulation of ZKSCAN3 expression as a potential underlying mechanism.
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Affiliation(s)
- Takashi Kawahara
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Yuki Teramoto
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Yi Li
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
| | - Hitoshi Ishiguro
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Kanagawa Institute of Industrial Science and Technology, Kawasaki 210-0821, Japan
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Jennifer Gordetsky
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
- Department of Urology, University of Rochester Medical Center, Rochester, NY 14642, USA
- Departments of Pathology and Urology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Zhiming Yang
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
| | - Hiroshi Miyamoto
- Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA; (T.K.); (Y.T.); (Y.L.); (H.I.); (J.G.); (Z.Y.)
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
- Department of Urology, University of Rochester Medical Center, Rochester, NY 14642, USA
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Racial differences in prostate cancer: does timing of puberty play a role? Br J Cancer 2020; 123:349-354. [PMID: 32439935 PMCID: PMC7403332 DOI: 10.1038/s41416-020-0897-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 12/19/2022] Open
Abstract
The burden of prostate cancer has a remarkably disproportionate distribution across racial groups. For example, in the USA, African Americans are twice as likely as individuals of European ancestry to develop or die from prostate cancer, and have a more aggressive disease nature at diagnosis. In contrast, Asian American men have the lowest incidence and mortality rates of prostate cancer. That considerable racial disparities exist even in the subclinical stage of prostate cancer among young men in their 20–30s suggests that patterns of prostate carcinogenesis start to diverge even earlier, perhaps during puberty, when the prostate matures at its most rapid rate. Mendelian randomisation studies have provided strong population-based evidence supporting the hypothesis that earlier onset of puberty increases the risk of prostate cancer—particularly of high grade—and prostate cancer-specific mortality later in life, observations which correspond to the epidemiology of the disease in African Americans. Notably, African American boys initiate genital development ~1 year earlier and thus go through longer periods of pubertal maturation compared with European American boys. In this perspective, bringing together existing evidence, we point to puberty as a potential critical window of increased susceptibility to prostate carcinogenesis that could account for the marked prevailing racial differences in the burden of prostate cancer.
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Seikkula H, Kaipia A, Hirvonen E, Rantanen M, Pitkäniemi J, Malila N, Boström PJ. Vasectomy and the risk of prostate cancer in a Finnish nationwide population-based cohort. Cancer Epidemiol 2019; 64:101631. [PMID: 31760357 DOI: 10.1016/j.canep.2019.101631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION & OBJECTIVES There are conflicting reports on the association of vasectomy and the risk of prostate cancer (PCa). Our objective was to evaluate the association between vasectomy and PCa from a nationwide cohort in Finland. MATERIALS & METHODS Sterilization registry of Finland and the Finnish Cancer Registry data were utilized to identify all men who underwent vasectomy between years 1987-2014 in Finland. Standard incidence ratio (SIR) for PCa as well as all-cause standardized mortality ratios (SMR) were calculated. RESULTS We identified 38,124 men with vasectomy with a total of 429,937 person-years follow-up data. The median age at vasectomy was 39.7 years (interquartile range [IQR] 35.9-44.0), after vasectomy PCa was diagnosed in 413 men (122 cases 0-10 years, 219 cases 10-20 years and 72 cases >20 years from vasectomy). SIR for PCa for the vasectomy cohort was 1.15 (95% CI: 1.04-1.27). By the end of follow-up, 19 men had died from PCa, while the expected number was 20.5 (SMR 0.93 [95%CI: 0.56-1.44]). The overall mortality was decreased (SMR 0.54 [95%CI: 0.51-0.58]) among men with vasectomy. CONCLUSION We found a small statistically significant increase in PCa incidence after vasectomy, but in contrast the mortality of vasectomized men was significantly reduced. This may be due to higher likelihood of vasectomized men to undergo prostate-specific antigen testing, having healthier general lifestyle and other biological factors e.g. high reproductive fitness.
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Affiliation(s)
- Heikki Seikkula
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland Keskussairaalantie 19, 40620, Jyväskylä, Finland.
| | - Antti Kaipia
- Department of Urology, Tampere University Hospital, Tampere, Finland PL 2000, 33521 Tampere, Finland.
| | - Elli Hirvonen
- Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland.
| | - Matti Rantanen
- Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland.
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland.
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland Unioninkatu 22, 00130, Helsinki, Finland; School of Health Sciences, University of Tampere, Finland.
| | - Peter J Boström
- Department of Urology, Turku University Hospital, Turku, Finland, Department of Urology, University of Turku, Turku, Finland Kiinamyllynkatu 4-8, 20100, Turku, Finland.
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Minas TZ, Tang W, Smith CJ, Onabajo OO, Obajemu A, Dorsey TH, Jordan SV, Obadi OM, Ryan BM, Prokunina-Olsson L, Loffredo CA, Ambs S. IFNL4-ΔG is associated with prostate cancer among men at increased risk of sexually transmitted infections. Commun Biol 2018; 1:191. [PMID: 30456312 PMCID: PMC6235841 DOI: 10.1038/s42003-018-0193-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/02/2018] [Indexed: 11/09/2022] Open
Abstract
Sexually transmitted infections can reach the prostate gland where their harmful effects are mediated by innate immunity, including interferons. Humans are polymorphic for the germline dinucleotide variant, rs368234815-TT/ΔG, in the IFNL4 gene encoding interferon λ4. Since the IFNL4-ΔG allele has been linked to impaired viral clearance, we hypothesized that potential exposure to sexually transmitted pathogens, as assessed by the number of lifetime sexual partners, may increase prostate cancer risk in an IFNL4-ΔG-dependent manner. Accordingly, we find that men with 10 or more sexual partners and at least one copy of IFNL4-ΔG have a significantly increased risk of prostate cancer while those with the same number of partners but lacking IFNL4-ΔG do not. Moreover, a test for effect modification shows a positive interaction between the number of lifetime partners and IFNL4-ΔG in the development of aggressive prostate cancer. Based on these findings, we conclude that a gene-environment interaction between IFNL4-ΔG and sexual activity may increase the risk of prostate cancer.
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Affiliation(s)
- Tsion Zewdu Minas
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Wei Tang
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Cheryl J Smith
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Olusegun O Onabajo
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, MD, USA
| | - Adeola Obajemu
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, MD, USA
| | - Tiffany H Dorsey
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Symone V Jordan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Obadi M Obadi
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Bríd M Ryan
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Ludmila Prokunina-Olsson
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, MD, USA
| | - Christopher A Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA.
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Jian Z, Ye D, Chen Y, Li H, Wang K. Sexual Activity and Risk of Prostate Cancer: A Dose-Response Meta-Analysis. J Sex Med 2018; 15:1300-1309. [PMID: 30122473 DOI: 10.1016/j.jsxm.2018.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The role of sexual activity (SA) on prostate cancer (PCa) risk is still controversial. AIM To determine the associations among number of female sexual partners, age at first intercourse, ejaculation frequency (EF), and the risk of PCa. METHODS A systematic literature search on MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify the relevant studies published before April 2018. We calculated the summary odds ratio (OR) and 95% CI to determine the association between SA and PCa risk. A 2-stage dose-response meta-analysis was performed to explore the trend from the correlated log OR estimates. MAIN OUTCOME MEASURES Outcome measures included characteristics of included studies, associations among number of female sexual partners, age at first intercourse, as well as EF and PCa risk. RESULTS A total of 21 case-control studies and 1 cohort study with 55,490 participants (14,976 patients and 40,514 controls) were included in this meta-analysis. Linear and significant dose-response associations were found among number of female sexual partner as well as age at first intercourse and PCa risk, an increment of 10 female sexual partners associated with a 1.10-fold increase of PCa risk (OR 1.10, 95% CI 1.01-1.21), and the risk of PCa was decreased by 4% for every 5-year delay in age at first intercourse (OR 0.96, 95% CI 0.92-0.99). Although no linear association was observed between EF and the risk of PCa, moderate EF (2-4 times per week) was significantly associated with a lower risk of PCa (OR 0.91, 95% CI 0.87-0.96). CLINICAL IMPLICATIONS Modification of SA factors would appear to be a useful low-risk approach to decreasing the risk of PCa. STRENGTHS & LIMITATIONS This is the first dose-response meta-analysis performed to describe the association between SA and PCa risk. However, the direction of causality between SA and risk of PCa should be interpreted with caution because most included studies used case-control design. CONCLUSION Meta-analysis of the included studies indicated that men with fewer sexual partner numbers, older age at first intercourse, and moderate frequent ejaculation were associated with a significantly decreased risk of PCa. Jian Z, Ye D, Chen Y, et al. Sexual Activity and Risk of Prostate Cancer: A Dose-Response Meta-Analysis. J Sex Med 2018;15:1300-1309.
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Affiliation(s)
- Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Donghui Ye
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yuntian Chen
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Hong Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
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Bhindi B, Wallis CJD, Nayan M, Farrell AM, Trost LW, Hamilton RJ, Kulkarni GS, Finelli A, Fleshner NE, Boorjian SA, Karnes RJ. The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis. JAMA Intern Med 2017; 177:1273-1286. [PMID: 28715534 PMCID: PMC5710573 DOI: 10.1001/jamainternmed.2017.2791] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 05/07/2017] [Indexed: 12/30/2022]
Abstract
Importance Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer. Objective To determine if vasectomy is associated with prostate cancer. Data Sources The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched for studies indexed from database inception to March 21, 2017, without language restriction. Study Selection Cohort, case-control, and cross-sectional studies reporting relative effect estimates for the association between vasectomy and prostate cancer were included. Data Extraction and Synthesis Two investigators performed study selection independently. Data were pooled separately by study design type using random-effects models. The Newcastle-Ottawa Scale was used to assess risk of bias. Main Outcomes and Measures The primary outcome was any diagnosis of prostate cancer. Secondary outcomes were high-grade, advanced, and fatal prostate cancer. Results Fifty-three studies (16 cohort studies including 2 563 519 participants, 33 case-control studies including 44 536 participants, and 4 cross-sectional studies including 12 098 221 participants) were included. Of these, 7 cohort studies (44%), 26 case-control studies (79%), and all 4 cross-sectional studies were deemed to have a moderate to high risk of bias. Among studies deemed to have a low risk of bias, a weak association was found among cohort studies (7 studies; adjusted rate ratio, 1.05; 95% CI, 1.02-1.09; P < .001; I2 = 9%) and a similar but nonsignificant association was found among case-control studies (6 studies; adjusted odds ratio, 1.06; 95% CI, 0.88-1.29; P = .54; I2 = 37%). Effect estimates were further from the null when studies with a moderate to high risk of bias were included. Associations between vasectomy and high-grade prostate cancer (6 studies; adjusted rate ratio, 1.03; 95% CI, 0.89-1.21; P = .67; I2 = 55%), advanced prostate cancer (6 studies; adjusted rate ratio, 1.08; 95% CI, 0.98-1.20; P = .11; I2 = 18%), and fatal prostate cancer (5 studies; adjusted rate ratio, 1.02; 95% CI, 0.92-1.14; P = .68; I2 = 26%) were not significant (all cohort studies). Based on these data, a 0.6% (95% CI, 0.3%-1.2%) absolute increase in lifetime risk of prostate cancer associated with vasectomy and a population-attributable fraction of 0.5% (95% CI, 0.2%-0.9%) were calculated. Conclusions and Relevance This review found no association between vasectomy and high-grade, advanced-stage, or fatal prostate cancer. There was a weak association between vasectomy and any prostate cancer that was closer to the null with increasingly robust study design. This association is unlikely to be causal and should not preclude the use of vasectomy as a long-term contraceptive option.
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Affiliation(s)
- Bimal Bhindi
- Department of Urology, Mayo Clinic, Rochester, Minnesota
| | - Christopher J. D. Wallis
- Division of Urology, Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Madhur Nayan
- Division of Urology, Department of Surgery, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Ann M. Farrell
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota
| | | | - Robert J. Hamilton
- Division of Urology, Department of Surgery, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Girish S. Kulkarni
- Division of Urology, Department of Surgery, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Department of Surgery, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Neil E. Fleshner
- Division of Urology, Department of Surgery, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
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Shoag J, Savenkov O, Christos PJ, Mittal S, Halpern JA, Askin G, Shoag D, Golan R, Lee DJ, O'Malley P, Najari B, Eisner B, Hu JC, Scherr D, Schlegel P, Barbieri CE. Vasectomy and Risk of Prostate Cancer in a Screening Trial. Cancer Epidemiol Biomarkers Prev 2017; 26:1653-1659. [PMID: 28830873 DOI: 10.1158/1055-9965.epi-16-0776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/30/2016] [Accepted: 08/11/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Vasectomy has been implicated as a risk factor for prostate cancer in multiple epidemiologic studies over the past 25 years. Whether this relationship is causal remains unclear. This study examines the association between vasectomy and prostate cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, which randomized men to usual care or annual prostate cancer screening.Methods: We performed a retrospective analysis of 13-year screening and outcomes data from the PLCO trial. Multivariable Cox proportional hazards regression stratified by study arm and age at vasectomy was performed.Results: There was an increased risk of prostate cancer in men who had undergone a vasectomy and were randomized to the usual care arm of the study (adjusted HR, 1.11; 95% confidence interval, 1.03-1.20; P = 0.008). There was no association between vasectomy and diagnosis of prostate cancer in men randomized to the prostate cancer screening arm. Only men undergoing vasectomy at an older age in the usual care arm of the study, but not the prostate cancer screening arm, were at increased risk of being diagnosed with prostate cancer.Conclusions: Vasectomy was not associated with prostate cancer risk among men who were screened for prostate cancer as part of a clinical trial, but was associated with prostate cancer detection in men receiving usual care.Impact: The positive association between vasectomy and prostate cancer is likely related to increased detection of prostate cancer based on patterns of care rather than a biological effect of vasectomy on prostate cancer development. Cancer Epidemiol Biomarkers Prev; 26(11); 1653-9. ©2017 AACR.
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Affiliation(s)
- Jonathan Shoag
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York.
| | - Oleksander Savenkov
- Department of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, New York
| | - Paul J Christos
- Department of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, New York
| | - Sameer Mittal
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Joshua A Halpern
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Gulce Askin
- Department of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, New York
| | - Daniel Shoag
- Department of Public Policy, Harvard Kennedy School, Cambridge, Massachusetts
| | - Ron Golan
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Daniel J Lee
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Padraic O'Malley
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York.,Department of Urology, Dalhousie University, Halifax, Nova Scotia
| | - Bobby Najari
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Brian Eisner
- Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jim C Hu
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Douglas Scherr
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Peter Schlegel
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Christopher E Barbieri
- Department of Urology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York.,Sandra and Edward Meyer Cancer Center, Weill Cornell Medical College, New York, New York
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11
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Nayan M, Hamilton RJ, Macdonald EM, Li Q, Mamdani MM, Earle CC, Kulkarni GS, Jarvi KA, Juurlink DN. Vasectomy and risk of prostate cancer: population based matched cohort study. BMJ 2016; 355:i5546. [PMID: 27811008 PMCID: PMC5094198 DOI: 10.1136/bmj.i5546] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine the association between vasectomy and prostate cancer, adjusting for measures of health seeking behaviour. DESIGN Population based matched cohort study. SETTING Multiple validated healthcare databases in Ontario, Canada, 1994-2012. PARTICIPANTS 326 607 men aged 20 to 65 who had undergone vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a vasectomy. MAIN OUTCOMES MEASURES The primary outcome was incident prostate cancer. Secondary outcomes were prostate cancer related grade, stage, and mortality. RESULTS 3462 incident cases of prostate cancer were identified after a median follow-up of 10.9 years: 1843 (53.2%) in the vasectomy group and 1619 (46.8%) in the non-vasectomy group. In unadjusted analysis, vasectomy was associated with a slightly increased risk of incident prostate cancer (hazard ratio 1.13, 95% confidence interval 1.05 to 1.20). After adjustment for measures of health seeking behaviour, however, no association remained (adjusted hazard ratio 1.02, 95% confidence interval 0.95 to 1.09). Moreover, no association was found between vasectomy and high grade prostate cancer (adjusted odds ratio 1.05, 95% confidence interval 0.67 to 1.66), advanced stage prostate cancer (adjusted odds ratio 1.04, 0.81 to 1.34), or mortality (adjusted hazard ratio 1.06, 0.60 to 1.85). CONCLUSION The findings do not support an independent association between vasectomy and prostate cancer.
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Affiliation(s)
- Madhur Nayan
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada
| | - Robert J Hamilton
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada
| | | | - Qing Li
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Muhammad M Mamdani
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
| | - Craig C Earle
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Girish S Kulkarni
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Ave 3-130, Toronto, ON, M5G 2M9, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Keith A Jarvi
- Division of Urology, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada; Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - David N Juurlink
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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12
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Nutt M, Reed Z, Köhler TS. Vasectomy and prostate cancer risk: a historical synopsis of undulating false causality. Res Rep Urol 2016; 8:85-93. [PMID: 27486569 PMCID: PMC4958361 DOI: 10.2147/rru.s71325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The potential influence of vasectomy being a risk factor for the development of prostate cancer is not a new concept, with more than 30 publications addressing the topic. Given the global frequency of vasectomy and the prevalence of prostate cancer, this subject justifiably deserves scrutiny. Several articles have claimed that vasectomy puts men at risk for future development of prostate cancer. We explore articles that have shown the contrary (no link), explore the studies’ strengths and weaknesses, describe possible prostate cancer pathophysiologic mechanisms, and apply Bradford Hill criteria to help discern correlation with causation. The risk and interest of association of prostate cancer with vasectomy has waxed and waned over the last three decades. Based on our review, vasectomy remains a safe form of sterilization and does not increase prostate cancer risk.
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Affiliation(s)
- Max Nutt
- Division of Urology, Southern Illinois University School of Medicine, Urology, Springfield, IL, USA
| | - Zachary Reed
- Division of Urology, Southern Illinois University School of Medicine, Urology, Springfield, IL, USA
| | - Tobias S Köhler
- Division of Urology, Southern Illinois University School of Medicine, Urology, Springfield, IL, USA
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13
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Bonilla C, Lewis SJ, Martin RM, Donovan JL, Hamdy FC, Neal DE, Eeles R, Easton D, Kote-Jarai Z, Al Olama AA, Benlloch S, Muir K, Giles GG, Wiklund F, Gronberg H, Haiman CA, Schleutker J, Nordestgaard BG, Travis RC, Pashayan N, Khaw KT, Stanford JL, Blot WJ, Thibodeau S, Maier C, Kibel AS, Cybulski C, Cannon-Albright L, Brenner H, Park J, Kaneva R, Batra J, Teixeira MR, Pandha H, Lathrop M, Davey Smith G. Pubertal development and prostate cancer risk: Mendelian randomization study in a population-based cohort. BMC Med 2016; 14:66. [PMID: 27044414 PMCID: PMC4820939 DOI: 10.1186/s12916-016-0602-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/16/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Epidemiological studies have observed a positive association between an earlier age at sexual development and prostate cancer, but markers of sexual maturation in boys are imprecise and observational estimates are likely to suffer from a degree of uncontrolled confounding. To obtain causal estimates, we examined the role of pubertal development in prostate cancer using genetic polymorphisms associated with Tanner stage in adolescent boys in a Mendelian randomization (MR) approach. METHODS We derived a weighted genetic risk score for pubertal development, combining 13 SNPs associated with male Tanner stage. A higher score indicated a later puberty onset. We examined the association of this score with prostate cancer risk, stage and grade in the UK-based ProtecT case-control study (n = 2,927), and used the PRACTICAL consortium (n = 43,737) as a replication sample. RESULTS In ProtecT, the puberty genetic score was inversely associated with prostate cancer grade (odds ratio (OR) of high- vs. low-grade cancer, per tertile of the score: 0.76; 95 % CI, 0.64-0.89). In an instrumental variable estimation of the causal OR, later physical development in adolescence (equivalent to a difference of one Tanner stage between pubertal boys of the same age) was associated with a 77 % (95 % CI, 43-91 %) reduced odds of high Gleason prostate cancer. In PRACTICAL, the puberty genetic score was associated with prostate cancer stage (OR of advanced vs. localized cancer, per tertile: 0.95; 95 % CI, 0.91-1.00) and prostate cancer-specific mortality (hazard ratio amongst cases, per tertile: 0.94; 95 % CI, 0.90-0.98), but not with disease grade. CONCLUSIONS Older age at sexual maturation is causally linked to a reduced risk of later prostate cancer, especially aggressive disease.
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Affiliation(s)
- Carolina Bonilla
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
- />MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Sarah J. Lewis
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
- />MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Richard M. Martin
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
- />MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- />National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Bristol, UK
| | - Jenny L. Donovan
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Freddie C. Hamdy
- />Nuffield Department of Surgery, University of Oxford, Oxford, UK
| | - David E. Neal
- />Nuffield Department of Surgery, University of Oxford, Oxford, UK
- />Surgical Oncology (Uro-Oncology: S4), University of Cambridge, Box 279, Addenbrooke’s Hospital, Hills Road, Cambridge, UK
| | - Rosalind Eeles
- />The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG Surrey UK
- />The Royal Marsden NHS Foundation Trust, Fulham and Sutton London and Surrey, UK
| | - Doug Easton
- />Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
| | - Zsofia Kote-Jarai
- />The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG Surrey UK
| | - Ali Amin Al Olama
- />Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
| | - Sara Benlloch
- />Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
| | - Kenneth Muir
- />University of Warwick, Coventry, UK
- />Institute of Population Health, The University of Manchester, Manchester, M13 9PL UK
| | - Graham G. Giles
- />The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004 Australia
- />Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Fredrik Wiklund
- />Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Henrik Gronberg
- />Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Christopher A. Haiman
- />Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA USA
| | - Johanna Schleutker
- />Department of Medical Biochemistry and Genetics, University of Turku, Turku, Finland
- />Institute of Biomedical Technology/BioMediTech, University of Tampere and FimLab Laboratories, Tampere, Finland
| | - Børge G. Nordestgaard
- />Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev, DK-2730 Denmark
| | - Ruth C. Travis
- />Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Nora Pashayan
- />Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
- />Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Kay-Tee Khaw
- />Cambridge Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - Janet L. Stanford
- />Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
- />Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA USA
| | - William J. Blot
- />International Epidemiology Institute, 1455 Research Blvd., Suite 550, Rockville, MD 20850 USA
| | | | - Christiane Maier
- />Department of Urology, University Hospital Ulm, Ulm, Germany
- />Institute of Human Genetics, University Hospital Ulm, Ulm, Germany
| | - Adam S. Kibel
- />Brigham and Women’s Hospital/Dana-Farber Cancer Institute, 45 Francis Street - ASB II-3, Boston, MA 02115 USA
- />Washington University, St Louis, MO USA
| | - Cezary Cybulski
- />International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Lisa Cannon-Albright
- />Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Hermann Brenner
- />Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- />Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- />German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jong Park
- />Division of Cancer Prevention and Control, H. Lee Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL USA
| | - Radka Kaneva
- />Molecular Medicine Center and Department of Medical Chemistry and Biochemistry, Medical University-Sofia, 2 Zdrave St., Sofia, 1431 Bulgaria
| | - Jyotsna Batra
- />Australian Prostate Cancer Research Centre – Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Manuel R. Teixeira
- />Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- />Biomedical Sciences Institute (ICBAS), Porto University, Porto, Portugal
| | - Hardev Pandha
- />The University of Surrey, Guildford, Surrey GU2 7XH UK
| | - Mark Lathrop
- />Commissariat à l’Energie Atomique, Center National de Génotypage, Evry, France
- />McGill University-Génome Québec Innovation Centre, Montreal, Canada
| | - George Davey Smith
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
- />MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - The PRACTICAL consortium
- />School of Social and Community Medicine, University of Bristol, Bristol, UK
- />MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- />National Institute for Health Research, Bristol Biomedical Research Unit in Nutrition, Bristol, UK
- />Nuffield Department of Surgery, University of Oxford, Oxford, UK
- />Surgical Oncology (Uro-Oncology: S4), University of Cambridge, Box 279, Addenbrooke’s Hospital, Hills Road, Cambridge, UK
- />The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG Surrey UK
- />The Royal Marsden NHS Foundation Trust, Fulham and Sutton London and Surrey, UK
- />Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
- />University of Warwick, Coventry, UK
- />Institute of Population Health, The University of Manchester, Manchester, M13 9PL UK
- />The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004 Australia
- />Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010 Australia
- />Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- />Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA USA
- />Department of Medical Biochemistry and Genetics, University of Turku, Turku, Finland
- />Institute of Biomedical Technology/BioMediTech, University of Tampere and FimLab Laboratories, Tampere, Finland
- />Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Herlev, DK-2730 Denmark
- />Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- />Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Worts Causeway Cambridge, UK
- />Department of Applied Health Research, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
- />Cambridge Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
- />Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
- />Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA USA
- />International Epidemiology Institute, 1455 Research Blvd., Suite 550, Rockville, MD 20850 USA
- />Mayo Clinic, Rochester, MN USA
- />Department of Urology, University Hospital Ulm, Ulm, Germany
- />Institute of Human Genetics, University Hospital Ulm, Ulm, Germany
- />Brigham and Women’s Hospital/Dana-Farber Cancer Institute, 45 Francis Street - ASB II-3, Boston, MA 02115 USA
- />Washington University, St Louis, MO USA
- />International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- />Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT USA
- />Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- />Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- />German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- />Division of Cancer Prevention and Control, H. Lee Moffitt Cancer Center, 12902 Magnolia Dr., Tampa, FL USA
- />Molecular Medicine Center and Department of Medical Chemistry and Biochemistry, Medical University-Sofia, 2 Zdrave St., Sofia, 1431 Bulgaria
- />Australian Prostate Cancer Research Centre – Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
- />Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- />Biomedical Sciences Institute (ICBAS), Porto University, Porto, Portugal
- />The University of Surrey, Guildford, Surrey GU2 7XH UK
- />Commissariat à l’Energie Atomique, Center National de Génotypage, Evry, France
- />McGill University-Génome Québec Innovation Centre, Montreal, Canada
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14
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Rider JR, Wilson KM, Sinnott JA, Kelly RS, Mucci LA, Giovannucci EL. Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. Eur Urol 2016; 70:974-982. [PMID: 27033442 DOI: 10.1016/j.eururo.2016.03.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Evidence suggests that ejaculation frequency may be inversely related to the risk of prostate cancer (PCa), a disease for which few modifiable risk factors have been identified. OBJECTIVE To incorporate an additional 10 yr of follow-up into an original analysis and to comprehensively evaluate the association between ejaculation frequency and PCa, accounting for screening, clinically relevant disease subgroups, and the impact of mortality from other causes. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study of participants in the Health Professionals Follow-up Study utilizing self-reported data on average monthly ejaculation frequency. The study includes 31925 men who answered questions on ejaculation frequency on a 1992 questionnaire and followed through to 2010. The average monthly ejaculation frequency was assessed at three time points: age 20-29 yr, age 40-49 yr, and the year before questionnaire distribution. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Incidence of total PCa and clinically relevant disease subgroups. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS AND LIMITATIONS During 480831 person-years, 3839 men were diagnosed with PCa. Ejaculation frequency at age 40-49 yr was positively associated with age-standardized body mass index, physical activity, divorce, history of sexually transmitted infections, and consumption of total calories and alcohol. Prostate-specific antigen (PSA) test utilization by 2008, number of PSA tests, and frequency of prostate biopsy were similar across frequency categories. In multivariable analyses, the hazard ratio for PCa incidence for ≥21 compared to 4-7 ejaculations per month was 0.81 (95% confidence interval [CI] 0.72-0.92; p<0.0001 for trend) for frequency at age 20-29 yr and 0.78 (95% CI 0.69-0.89; p<0.0001 for trend) for frequency at age 40-49 yr. Associations were driven by low-risk disease, were similar when restricted to a PSA-screened cohort, and were unlikely to be explained by competing causes of death. CONCLUSIONS These findings provide additional evidence of a beneficial role of more frequent ejaculation throughout adult life in the etiology of PCa, particularly for low-risk disease. PATIENT SUMMARY We evaluated whether ejaculation frequency throughout adulthood is related to prostate cancer risk in a large US-based study. We found that men reporting higher compared to lower ejaculatory frequency in adulthood were less likely to be subsequently diagnosed with prostate cancer.
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Affiliation(s)
- Jennifer R Rider
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Kathryn M Wilson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jennifer A Sinnott
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rachel S Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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15
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Boxall N, Bennett D, Hunger M, Dolin P, Thompson PL. Evaluation of exposure to pioglitazone and risk of prostate cancer: a nested case-control study. BMJ Open Diabetes Res Care 2016; 4:e000303. [PMID: 28074141 PMCID: PMC5174825 DOI: 10.1136/bmjdrc-2016-000303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/24/2016] [Accepted: 10/02/2016] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Investigate potential association between pioglitazone exposure and risk of prostate cancer. RESEARCH DESIGN AND METHODS Nested, matched case-control study. UK primary care data (Clinical Practice Research Datalink (CPRD) GOLD) linked to inpatient (Hospital Episode Statistics (HES)) and cancer registry (National Cancer Information Network (NCIN)) data. English men aged ≥40 years diagnosed with type 2 diabetes mellitus, January 1, 2001 to January 5, 2015. Cases, with prostate cancer diagnosis, matched with up to 4 controls by age, cohort entry date and region. ORs for association of exposure to pioglitazone to incident prostate cancer, adjusted for potential confounders. RESULTS From a cohort of 47 772 men with 243 923 person-years follow-up, 756 definite cases of prostate cancer were identified. Incidence was 309.9/100 000 person-years (95% CI 288.6 to 332.8). Pioglitazone use was not associated with prostate cancer risk; adjusted OR 0.759, 95% CI 0.502 to 1.148. Analyses showed no difference when possible cases, prostate cancer in CPRD GOLD only, included (adjusted OR 0.726, 95% CI 0.510 to 1.034). No association when adjusted for channeling bias (OR 0.778, 95% CI 0.511 to 1.184) or limited to an index date prior to July 1, 2011 (adjusted OR 0.508, 95% CI 0.294 to 0.879), despite prostate-specific antigen screening occurring more frequently among cases than controls (81.6% of 756 definite cases cf. 24.2% of 2942 controls (p<0.01)). No association with duration of pioglitazone use, increasing pioglitazone dose or increasing time since initiation. CONCLUSIONS In this real-world, nested matched case-control study, exposure to pioglitazone was not associated with increased risk of prostate cancer.
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Affiliation(s)
- Naomi Boxall
- Real World Strategy and Analytics, Mapi, London, UK
| | - Dimitri Bennett
- Takeda Pharmaceutical Company Limited, Global Risk Management and Pharmacoepidemiology, Cambridge, Massachusetts, USA
| | | | - Paul Dolin
- Takeda Pharmaceutical Company Limited, Global Risk Management and Pharmacoepidemiology, London, UK
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17
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Lian WQ, Luo F, Song XL, Lu YJ, Zhao SC. Gonorrhea and Prostate Cancer Incidence: An Updated Meta-Analysis of 21 Epidemiologic Studies. Med Sci Monit 2015; 21:1902-10. [PMID: 26126881 PMCID: PMC4502545 DOI: 10.12659/msm.893579] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/09/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The association between gonorrhea and prostate cancer risk has been investigated widely, but the results remain inconsistent and contradictory. We conducted an updated meta-analysis to obtain a more precise estimate of this association. MATERIAL AND METHODS PubMed, EMBASE, and the Cochrane Library were searched for papers up to June 2014 to identify eligible studies. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the influence of gonorrhea on prostate cancer risk. RESULTS Twenty-one observational studies (19 case-control and 2 cohort) were eligible, comprising 9965 prostate cancer patients and 118 765 participants. Pooled results indicated that gonorrhea was significantly associated with increased incidence of prostate cancer (OR 1.31, 95% CI 1.14-1.52). The association between gonorrhea and prostate cancer was stronger in African American males (OR 1.32, 95% CI 1.06-1.65) than in Whites (OR 1.05, 95% CI 0.90-1.21). CONCLUSIONS Our findings suggest that gonorrhea is associated with an increased risk of prostate cancer, especially among African American males. These results warrant further well-designed, large-scale cohort studies to draw definitive conclusions.
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Affiliation(s)
- Wen-Qing Lian
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Fei Luo
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Xian-Lu Song
- Department of Radiotherapy, Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
| | - Yong-Jie Lu
- Department of Molecular Oncology, Barts Cancer Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - Shan-Chao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China
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18
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Liu LH, Kang R, He J, Zhao SK, Li FT, Wan SP, Zhao ZG. Vasectomy and risk of prostate cancer: a systematic review and meta-analysis of cohort studies. Andrology 2015; 3:643-9. [PMID: 26041315 DOI: 10.1111/andr.12040] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/13/2015] [Accepted: 03/27/2015] [Indexed: 01/11/2023]
Affiliation(s)
- L. H. Liu
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - R. Kang
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - J. He
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - S. K. Zhao
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - F. T. Li
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - S. P. Wan
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Z. G. Zhao
- Department of Urology & Andrology; Minimally Invasive Surgery Center; Guangdong Key Laboratory of Urology; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
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19
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Vasectomy and prostate cancer risk: a meta-analysis of cohort studies. Sci Rep 2015; 5:9920. [PMID: 25927401 PMCID: PMC4415590 DOI: 10.1038/srep09920] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/20/2015] [Indexed: 11/08/2022] Open
Abstract
Some studies have suggested that vasectomy is associated with the increased risk of prostate cancer, however, this conclusion is not supported by all the published studies. In order to examine the relationship between vasectomy and prostate cancer risk, we conducted a meta-analysis of cohort studies to clarify this controversial association. PubMed and Medline were used to identify the cohort studies that reported the association of vasectomy with prostate cancer risk from 1980 to January 2015. Based on a random effects model, the RR and 95% CI were used to assess the combined risk. In total, 10 cohort studies involving more than 7027 cases and 429914 participants were included. There was no significant relationship between vasectomy and prostate cancer risk, the pooled RR (95%CI) was 1.11[0.98, 1.27] (P = 0.109). In subgroup-analysis, the relationship between vasectomy and prostate cancer risk was not significantly modified by the length of follow-up and population distribution except Americans. Omission of any single study had little effect on the pooled risk estimate. Little evidence of publication bias was found. In conclusion, our meta-analysis suggests that vasectomy is not associated with the increased risk of prostate cancer. More studies based on other populations including the Chinese are needed.
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20
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Sexually transmitted infections and prostate cancer risk: a systematic review and meta-analysis. Cancer Epidemiol 2014; 38:329-38. [PMID: 24986642 DOI: 10.1016/j.canep.2014.06.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/04/2014] [Accepted: 06/10/2014] [Indexed: 12/25/2022]
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.
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Abstract
AIMS To measure the degree and direction of errors in recall of age at first sex. METHOD Participants were initially recruited in 1994-1995 (Wave I) with 3 subsequent follow-ups in: 1996 (Wave II); 2001- 2002 (Wave III); and 2007-2008 (Wave IV). Participants' individual errors in recall of their age at first sex at Wave IV were estimated by the paired difference between responses given for age at first sex in Wave I and Wave IV (recalled age at first sex obtained at Wave IV minus the age at first sex obtained at Wave I). RESULTS The mean of the recall-estimation of age at first sex at Wave IV was found to be slightly increased comparing to the age at first sex at Wave I (less than 1 year). The errors in the recalled age at first sex tended to increase in participants who had their first sex younger or older than the average, and the recalled age at first sex tended to bias towards the mean (i.e. participants who had first sex younger than the average were more likely to recall an age at first sex that was older than the age, and vice versa). CONCLUSIONS In this U.S. population-based sample, the average recall error for age at first sex was small. However, the accuracy of recalled information varied significantly among subgroup populations.
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Affiliation(s)
- Wenbin Liang
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- * E-mail:
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
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22
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Aspirin use is associated with lower prostate cancer risk in male carriers of BRCA mutations. J Genet Couns 2013; 23:187-91. [PMID: 23881471 DOI: 10.1007/s10897-013-9629-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 07/02/2013] [Indexed: 12/17/2022]
Abstract
Previous studies have shown that male BRCA mutation carriers stand at increased risk of developing prostate cancer and have concerns about developing cancer. Genetic counseling practitioners often discuss strategies for reducing the risk of cancer for patients at high risk due to their genetic background. Addressing modifiable health habits is one such strategy. Unfortunately, modifiable risk factors for prostate cancer have only been documented in the general population and have not yet been studied in the BRCA carrier subpopulation. Therefore, this study aimed to identify modifiable risk factors for prostate cancer in BRCA carriers. We examined prostate cancer risk factors in 74 men who were part of families with a BRCA mutation. This study examined nine dichotomous variables including: exercise, history of vasectomy, smoking history, alcohol use, finasteride use, statin use, aspirin use, coffee use, and vitamin use. The survey was sent to all cases of prostate cancer in the Hereditary Cancer Center Database at Creighton University with a known BRCA status. This study confirmed the protective benefits of daily aspirin use, which have been observed in previous studies of the general population, and suggests its benefit in BRCA carriers. Protective benefits from regular vigorous exercise and daily coffee use trended towards significance, but neither factor withstood the Bonferroni Correction for multiple comparisons.
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Hennis AJM, Wu SY, Nemesure B, Leske MC. Urologic characteristics and sexual behaviors associated with prostate cancer in an african-Caribbean population in barbados, west indies. Prostate Cancer 2013; 2013:682750. [PMID: 23533778 PMCID: PMC3596924 DOI: 10.1155/2013/682750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 01/09/2013] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer (PC) is the principal malignancy affecting African descent men in the Caribbean and the USA. Disparities in incidence, prevalence, and mortality in these populations are poorly understood. We evaluated the urologic characteristics and sexual behaviors of men with histologically confirmed PC (cases) and age-matched controls in the nationwide Prostate Cancer in a Black Population (PCBP) study conducted in Barbados. Cases were around 1.5 to 3 times more likely to report symptoms of prostatic enlargement, hematuria/hematospermia, and previous prostatitis. Sexually transmitted infections (STIs) were similar among cases (24.5%) and controls (26.7%). First sexual intercourse before the age of 16 was associated with an increased likelihood of both low- (Gleason score < 7; OR 1.63; 95% CI: 1.03-1.66) and high-grade PC (Gleason score ≥ 7; OR 1.82; 1.11-2.99). PC risk decreased with later age of sexual debut (P-trend = 0.004). More lifetime sexual partners was associated with increased odds of high grade PC (P-trend = 0.02). The contribution of sexual behaviors to the development and the outcomes of PC is likely due to multiple mechanisms, and further study will be necessary to elucidate the underlying pathophysiologic mechanisms in this and similar populations.
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Affiliation(s)
- Anselm J. M. Hennis
- Chronic Disease Research Centre, The University of the West Indies, Jemmott's Lane, St. Michael, BB11115, Barbados
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794-8036, USA
- Ministry of Health, Frank Walcott Building, Culloden Road, St. Michael, BB14001, Barbados
- Faculty of Medical Sciences, Cave Hill Campus, The University of the West Indies, St. Michael, BB11000, Barbados
| | - Suh-Yuh Wu
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794-8036, USA
| | - Barbara Nemesure
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794-8036, USA
| | - M. Cristina Leske
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794-8036, USA
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24
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The Role of Bacteria in Cancer Development. Infect Agent Cancer 2013. [DOI: 10.1007/978-94-007-5955-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Abstract
Quite a few epidemiological studies including meta-analyses indicate that prostate inflammation is associated with increased risk of prostate cancer. The cause of inflammation in the prostate is speculated to be several microorganisms that cause prostatitis or sexually transmitted infections. Other specific microorganisms, such as xenotropic murine leukemia virus-related virus, are also reported to relate to the development of prostate cancer; however, the contribution of this microorganism to prostate cancer development needs to be carefully interpreted. Environmental factors, especially dietary factors, might also be associated with prostate cancer development. Among related dietary factors, charred meat carcinogen 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine might be a link between environmental factors and inflammation, because 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine has the potential to accelerate prostate inflammation through its estrogenic effect. In light of these findings, preventing or reducing prostate inflammation might be one strategy for chemoprevention of prostate cancer.
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Affiliation(s)
- Yasutomo Nakai
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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26
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Russell LH, Mazzio E, Badisa RB, Zhu ZP, Agharahimi M, Oriaku ET, Goodman CB. Autoxidation of gallic acid induces ROS-dependent death in human prostate cancer LNCaP cells. Anticancer Res 2012; 32:1595-1602. [PMID: 22593437 PMCID: PMC3356927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Prostate cancer is the second most common cause of mortality. Gallic acid (GA) is a natural polyphenol, and we tested its in-vitro cytotoxicity after 24 h in prostate cancer LNCaP cells. MATERIALS AND METHODS GA autoxidation was measured fluorimetrically for H(2)O(2), and O(2)(•-) radicals by chemiluminescence. Intracellular reactive oxygen species (ROS) levels were detected with 2',7'-dichlorodihydrofluorescein diacetate. Cytotoxicity was evaluated by crystal-violet, while apoptosis and mitochondrial membrane potential were determined by flow cytometry. Cytochrome c release was detected by enzyme-linked immunosorbent assay, and caspase-8, -9 and -3 activities were measured calorimetrically. RESULTS GA autoxidation produced significant levels of H(2)O(2) and O2.-. Increased intracellular ROS levels with GA were reduced by N-acetyl-L-cysteine (NAC) and L-glutathione (GSH). Cells were protected against GA cytotoxicity when pretreated with increasing levels of superoxide dismutase/catalase mixture, NAC, or GSH for 3 h. The number of apoptotic cells increased with GA dose. GA caused mitochondrial potential loss, cytochrome c release, and activation of caspases 3, 8 and 9. CONCLUSION The ROS-dependent apoptotic mechanism of GA kills malignant cells effectively; it is likely that GA could be a good anticancer agent.
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Affiliation(s)
- Larry H Russell
- Neuropharmacology Section, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
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27
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Wright JL, Lin DW, Stanford JL. Circumcision and the risk of prostate cancer. Cancer 2012; 118:4437-43. [PMID: 22411189 DOI: 10.1002/cncr.26653] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 08/05/2011] [Accepted: 09/26/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several lines of evidence support a role for infectious agents in the development of prostate cancer (PCa). In particular, sexually transmitted infections (STIs) have been implicated in PCa etiology, and studies have found that the risk of acquiring a STI can be reduced with circumcision. Therefore, circumcision may reduce PCa risk. METHODS Participant data collected as part of 2 population-based case-control studies of PCa were analyzed. Self-reported circumcision status, age at circumcision, and age at first sexual intercourse were recorded along with a history of STIs or prostatitis. Multivariate logistic regression was used to estimate the relative risk of PCa by circumcision status. RESULTS Data from 1754 cases and 1645 controls were available. Circumcision before first sexual intercourse was associated with a 15% reduction in risk of PCa compared to that of uncircumcised men (95% confidence interval [CI], 0.73-0.99). This risk reduction was observed for cases with both less aggressive (odds ratio, 0.88; 95% CI, 0.74-1.04) and more aggressive (odds ratio, 0.82; 95% CI, 0.66-1.00) PCa features. CONCLUSIONS Circumcision before first sexual intercourse is associated with a reduction in the relative risk of PCa in this study population. These findings are consistent with research supporting the infectious/inflammation pathway in prostate carcinogenesis.
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Affiliation(s)
- Jonathan L Wright
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA.
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28
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Kiciński M, Vangronsveld J, Nawrot TS. An epidemiological reappraisal of the familial aggregation of prostate cancer: a meta-analysis. PLoS One 2011; 6:e27130. [PMID: 22073129 PMCID: PMC3205054 DOI: 10.1371/journal.pone.0027130] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022] Open
Abstract
Studies on familial aggregation of cancer may suggest an overall contribution of inherited genes or a shared environment in the development of malignant disease. We performed a meta-analysis on familial clustering of prostate cancer. Out of 74 studies reporting data on familial aggregation of prostate cancer in unselected populations retrieved by a Pubmed search and browsing references, 33 independent studies meeting the inclusion criteria were used in the analysis performed with the random effects model. The pooled rate ratio (RR) for first-degree family history, i.e. affected father or brother, is 2.48 (95% confidence interval: 2.25-2.74). The incidence rate for men who have a brother who got prostate cancer increases 3.14 times (CI:2.37-4.15), and for those with affected father 2.35 times (CI:2.02-2.72). The pooled estimate of RR for two or more affected first-degree family members relative to no history in father and in brother is 4.39 (CI:2.61-7.39). First-degree family history appears to increase the incidence rate of prostate cancer more in men under 65 (RR:2.87, CI:2.21-3.74), than in men aged 65 and older (RR:1.92, CI:1.49-2.47), p for interaction = 0.002. The attributable fraction among those having an affected first-degree relative equals to 59.7% (CI:55.6-63.5%) for men at all ages, 65.2% (CI:57.7-71.4%) for men younger than 65 and 47.9% (CI:37.1-56.8%) for men aged 65 or older. For those with a family history in 2 or more first-degree family members 77.2% (CI:65.4-85.0%) of prostate cancer incidence can be attributed to the familial clustering. Our combined estimates show strong familial clustering and a significant effect-modification by age meaning that familial aggregation was associated with earlier disease onset (before age 65).
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Affiliation(s)
- Michał Kiciński
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium.
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29
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Sutcliffe S. Sexually transmitted infections and risk of prostate cancer: review of historical and emerging hypotheses. Future Oncol 2010; 6:1289-311. [PMID: 20799875 DOI: 10.2217/fon.10.95] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Since the early 1950s when sexually transmitted infections (STIs) were first proposed as a possible risk factor for prostate cancer, numerous epidemiologic studies have been conducted. Initially, these studies were primarily small case-control studies with retrospective, self-reported assessments of a narrow range of STIs, typically either any STIs, or gonorrhea and syphilis. However, as new STIs have been discovered/recognized, new and better tests to detect histories of STIs have been developed, and new resources for prostate cancer research have been created, epidemiologic studies have expanded to include a wide range of STIs, and have moved towards more rigorous, prospective study designs and serological assessment of STI histories. The results of these studies are reviewed and discussed, as well as possible new avenues of research, such as Trichomonas vaginalis infection and infections not typically considered to be sexually transmitted.
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Affiliation(s)
- Siobhan Sutcliffe
- Department of Surgery & The Alvin J Siteman Cancer Center, Washington University School of Medicine, Rm. 5026, St. Louis, MO 63110, USA.
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30
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Thakur H, Gupta L, Sobti RC, Janmeja AK, Seth A, Singh SK. Association of GSTM1T1 genes with COPD and prostate cancer in north Indian population. Mol Biol Rep 2010; 38:1733-9. [PMID: 20842440 DOI: 10.1007/s11033-010-0287-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 09/02/2010] [Indexed: 11/25/2022]
Abstract
The glutathione S-transferase (GST) family of enzymes is known to play a pivotal role in phase II of biotransformation of xenobiotics, environmental carcinogens and pharmacological drugs. The objective of the present study was to investigate the role of GSTM1 and GSTT1 null genotypes as risk factors for chronic obstructive pulmonary disease (COPD) and prostate cancer. The subjects appraised were 200 COPD cases, 150 prostate cancer cases, 150 benign prostatic hyperplasia (BPH) cases, 200 age matched controls for COPD and 172 age matched controls for prostate cancer. GSTM1 and GSTT1 null genotype was found to confer 2.5 (OR 2.45; 95% CI 1.56-3.82; P value = 0.00008) and 2.4-fold (OR 2.39; 95% CI 1.36-4.20; P value = 0.002) significant higher risk for prostate cancer. Smoking imparted a 2.2-fold significant risk of prostate cancer cases (OR 2.23; 95% CI 1.36-3.65 P value = 0.001) and twofold risk in BPH (OR 2.09; 95% CI 1.26-3.46; P value = 0.005). In case of COPD only null genotype of GSTT1 has shown 2.1-fold (OR 2.11; 95% CI 1.22-3.62; P value = 0.007) significant increased risk.
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Affiliation(s)
- Hitender Thakur
- Department of Biotechnology, Panjab University, Chandigarh, India
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31
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Weinmann S, Shapiro JA, Rybicki BA, Enger SM, Van Den Eeden SK, Richert-Boe KE, Weiss NS. Medical history, body size, and cigarette smoking in relation to fatal prostate cancer. Cancer Causes Control 2009; 21:117-25. [PMID: 19816779 DOI: 10.1007/s10552-009-9441-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 09/19/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Prostate cancer has few known risk factors. As part of a population-based case-control study conducted in four health maintenance organizations, the authors examined the associations between fatal prostate cancer and several medical and behavioral characteristics. METHODS Cases were 768 health plan members who died of prostate adenocarcinoma during the period 1997-2001. We randomly selected controls (929) from the health plan membership and matched them to cases on health plan, age, race, and pattern of health plan membership. We examined medical records to obtain information on potential risk factors during the 10 years before the date on which prostate cancer was first suspected; the same reference date was used for the matched controls. RESULTS Anthropometric characteristics, as well as personal histories of benign prostatic hypertrophy, transurethral prostatectomy, cancer, diabetes, prostatitis, hypertension, and vasectomy were largely similar for cases and controls. Men who died from prostate cancer were more likely than controls to have been cigarette smokers according to the most recent smoking notation before the reference date (odds ratio 1.5, 95% confidence interval 1.1-2.0). CONCLUSIONS The observed increase in risk associated with recent cigarette smoking is consistent with the findings of several other studies. However, in contrast with some reports, we observed no connection between fatal prostate cancer and some prior health conditions or measures of body size.
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Affiliation(s)
- Sheila Weinmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
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32
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Köhler TS, Fazili AA, Brannigan RE. Putative health risks associated with vasectomy. Urol Clin North Am 2009; 36:337-45. [PMID: 19643236 DOI: 10.1016/j.ucl.2009.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Vasectomy is widely regarded as a safe method of contraception, but over the years there have been many reports suggesting putative health risks associated with the procedure. Concerns over the possible association of vasectomy with a number of medical conditions, including cardiovascular disease, testicular cancer, prostate cancer, psychologic distress, and a variety of immune complex-mediated disease processes have been reported. Most recently, a manuscript from the neurology literature has described an association between vasectomy and primary progressive aphasia, a rare variety of frontotemporal dementia. This article reviews the literature surrounding each of these purported health concerns. Because the ultimate findings have important ramifications for both informed consent of vasectomy patients and for public health, the reported health risks in question should be critically evaluated.
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Affiliation(s)
- Tobias S Köhler
- Division of Urology, Southern Illinois University, 747 North Rutledge, No. 9649, Springfield, IL 62702, USA
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33
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Schwingl PJ, Meirik O, Kapp N, Farley TMM. Prostate cancer and vasectomy: a hospital-based case-control study in China, Nepal and the Republic of Korea. Contraception 2009; 79:363-8. [PMID: 19341848 DOI: 10.1016/j.contraception.2008.11.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 11/21/2008] [Accepted: 11/21/2008] [Indexed: 12/14/2022]
Abstract
BACKGROUND The study of a possible relationship between vasectomy and prostate cancer has yielded mixed results. Data from developing countries are limited. STUDY DESIGN We conducted a hospital-based case-control study in China, Nepal and the Republic of Korea to evaluate the risk of prostate cancer after vasectomy. RESULTS Prostate cancer in 294 cases (confirmed by independent pathologists) and 879 matched controls were included. The odds ratio of prostate cancer in men with a history of vasectomy was 1.21 [95% confidence interval (95% CI)=0.79, 1.87]. No significant trend was observed in risk by time since vasectomy or age at vasectomy. The odds ratio for localized disease was 1.02 (95% CI=0.53, 1.95); the odds ratio for later stages was 1.41 (95% CI=0.78, 2.53). No confounding factor was identified. The study illustrated differential misclassification of disease by vasectomy status; reference pathologists determined that 28% of men with a history of vasectomy, compared with 17% of men without a history of vasectomy, were misdiagnosed with prostate cancer by local pathologists. CONCLUSION Vasectomy is not associated with an increased risk of prostate cancer in developing countries where the rate of the disease is low.
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Chen YC, Page JH, Chen R, Giovannucci E. Family history of prostate and breast cancer and the risk of prostate cancer in the PSA era. Prostate 2008; 68:1582-91. [PMID: 18646000 PMCID: PMC2574825 DOI: 10.1002/pros.20825] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND A family history of prostate cancer (PCa) or breast cancer (BCa) has been associated with the risk of PCa, but the risks were inconsistent in terms of the affected family members, and data in the PSA era are limited. METHODS This study included a subcohort of the Health Professionals Follow-Up Study composed of a highly PSA screened population from 1986 to 2004 with 3,695 PCa cases identified. Questionnaires and a food frequency questionnaire were administered every other and every 4 years, respectively. Family history of PCa and BCa was ascertained in 1990, 1992, and 1996. All statistics were two-sided. RESULTS A family history of PCa in both a father and brother(s) was associated with a 2.3-fold increased risk of PCa [95% confidence interval (CI) = 1.76-3.12]. Men with a father or brother(s) with a PCa diagnosis at age<60 and >or=60 had 2.16- and 1.95-fold increased risk of PCa, respectively. A family history of PCa was related to early-onset PCa (<65 years: RR = 2.25, 95% CI = 1.95-2.60) and weakly to late-onset PCa (>or=65 years: RR = 1.67, 95% CI = 1.52-1.85). History of BCa in a mother or a sister was associated with a 1.22-fold increased risk of PCa (95% CI = 1.08-1.38). CONCLUSION A family history of PCa or BCa significantly increases PCa risk. These associations are evident in a population with widespread PSA screening.
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Affiliation(s)
- Yen-Ching Chen
- Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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Li XM, Li J, Tsuji I, Nakaya N, Nishino Y, Zhao XJ. Mass screening-based case-control study of diet and prostate cancer in Changchun, China. Asian J Androl 2008; 10:551-60. [PMID: 18478158 DOI: 10.1111/j.1745-7262.2008.00384.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIM To investigate possible correlation factors for prostate cancer by a population-based case-control study in China. METHODS We carried out a mass screening of prostate cancer in Changchun, China, using a prostate-specific antigen assisted by Japan International Cooperation Agency. From June 1998 to December 2000, 3 940 men over 50 years old were screened. Of these, 29 men were diagnosed with prostate cancer. We selected 28 cases and matched them with controls of low prostate-specific antigen value (< 4.1 ng/mL) by 1:10 according to age and place of employment. A case-control study of diet and prostate cancer was then carried out. RESULTS After adjustment for education, body mass index (BMI), smoking, alcohol consumption, marriage and diet, intake of soybean product was discovered to be inversely related to prostate cancer. Men who consumed soybean product more than twice per week on different days had a multivariate odds ratio (OR) of 0.38 (95% confidence interval [CI], 0.13-1.12). In addition, men who consumed soybean products more than once per day had a multivariate OR of 0.29 (95% CI, 0.11-0.79) compared with men who consumed soybean products less than once per week. The P for trend was 0.02, which showed significant difference. There was no significant difference in P trend for any dairy food. Even when we matched the cases and controls by other criteria, we found that soybean food was the only preventive factor associated with prostate cancer. CONCLUSION Our study suggests that consumption of soybeans, one of the most popular foods in Asia, would decrease the risk of prostate cancer.
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Affiliation(s)
- Xiao-Meng Li
- School of Life Sciences, Northeast Normal University, Changchun, China.
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Golub MS, Collman GW, Foster PMD, Kimmel CA, Rajpert-De Meyts E, Reiter EO, Sharpe RM, Skakkebaek NE, Toppari J. Public health implications of altered puberty timing. Pediatrics 2008; 121 Suppl 3:S218-30. [PMID: 18245514 DOI: 10.1542/peds.2007-1813g] [Citation(s) in RCA: 326] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Changes in puberty timing have implications for the treatment of individual children, for the risk of later adult disease, and for chemical testing and risk assessment for the population. Children with early puberty are at a risk for accelerated skeletal maturation and short adult height, early sexual debut, potential sexual abuse, and psychosocial difficulties. Altered puberty timing is also of concern for the development of reproductive tract cancers later in life. For example, an early age of menarche is a risk factor for breast cancer. A low age at male puberty is associated with an increased risk for testicular cancer according to several, but not all, epidemiologic studies. Girls and, possibly, boys who exhibit premature adrenarche are at a higher risk for developing features of metabolic syndrome, including obesity, type 2 diabetes, and cardiovascular disease later in adulthood. Altered timing of puberty also has implications for behavioral disorders. For example, an early maturation is associated with a greater incidence of conduct and behavior disorders during adolescence. Finally, altered puberty timing is considered an adverse effect in reproductive toxicity risk assessment for chemicals. Recent US legislation has mandated improved chemical testing approaches for protecting children's health and screening for endocrine-disrupting agents, which has led to changes in the US Environmental Protection Agency's risk assessment and toxicity testing guidelines to include puberty-related assessments and to the validation of pubertal male and female rat assays for endocrine screening.
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Affiliation(s)
- Mari S Golub
- Department of Environmental Toxicology, University of California, Davis, California, USA
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Gallus S, Foschi R, Talamini R, Altieri A, Negri E, Franceschi S, Montella M, Dal Maso L, Ramazzotti V, La Vecchia C. Risk factors for prostate cancer in men aged less than 60 years: a case-control study from Italy. Urology 2008; 70:1121-6. [PMID: 18158031 DOI: 10.1016/j.urology.2007.07.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 05/02/2007] [Accepted: 07/03/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze the relationship between selected risk factors and prostate cancer risk in men younger than 60 years, using data from a large, multicenter, case-control study conducted in Italy. METHODS Cases were 219 patients, aged 45 to 59 years, with histologically confirmed prostate cancer, and controls were 431 men of the same age group, admitted in hospital for acute, non-neoplastic diseases. RESULTS A family history of prostate cancer (odds ratio [OR] = 5.5), brain cancer (OR = 3.7), and leukemia (OR = 6.2) were associated with prostate cancer risk. A significantly increased risk was found for high education level (OR = 3.3 for 12 or more years versus less than 7 years) and a decreased risk for physical activity (OR = 0.5 for active versus inactive). Coffee consumption was directly associated with risk of prostate cancer (OR = 1.9 for the third versus the first tertile). Bread consumption was directly related (OR = 1.6) and consumption of raw and total vegetables inversely related (OR = 0.6) to prostate cancer risk, although these associations were of borderline significance. No association emerged with marital status, body mass index, history of diabetes, alcohol drinking, and other considered foods. CONCLUSIONS This study confirms that some recognized risk factors, including family history of prostate cancer, high level of education, and low physical activity, are associated with prostate cancer risk in middle-aged men.
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Affiliation(s)
- Silvano Gallus
- Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
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Sutcliffe S, Giovannucci E, De Marzo AM, Leitzmann MF, Willett WC, Platz EA. Gonorrhea, syphilis, clinical prostatitis, and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2007; 15:2160-6. [PMID: 17119041 DOI: 10.1158/1055-9965.epi-05-0913] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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.
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Affiliation(s)
- Siobhan Sutcliffe
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Room E6138, 615 North Wolfe Street, Baltimore, MD 21205, USA
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Enokida H, Shiina H, Urakami S, Terashima M, Ogishima T, Li LC, Kawahara M, Nakagawa M, Kane CJ, Carroll PR, Igawa M, Dahiya R. Smoking influences aberrant CpG hypermethylation of multiple genes in human prostate carcinoma. Cancer 2006; 106:79-86. [PMID: 16323173 DOI: 10.1002/cncr.21577] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Aberrant CpG methylation profiles of gene promoters and their correlation with advanced pathologic features have been well investigated in prostate carcinoma (PC). Several case-control and prospective studies have revealed a positive association between current smoking and PC. The authors hypothesized that smoking influences both progression and prognosis of PC through CpG hypermethylation of related genes. METHODS A total of 164 PC patients (52 current, 30 former, and 82 never smokers) and 69 benign prostatic hyperplasia (BPH) patients were examined by methylation-specific PCR (MSP) for 3 genes: adenomatous polyposis coli (APC), glutathione S-transferase pi (GSTP1), and multidrug resistance one (MDR1). The methylation status of representative samples was confirmed by bisulfite DNA sequencing analysis. The newly defined methylation score (M-score) of each sample is the sum of the corresponding log hazard ratio (HR) coefficients derived from multivariate logistic regression analysis for pathology (BPH vs. PC), and was related to clinical and pathologic outcome including smoking status. RESULTS The M-score was significantly higher in the current smokers than in never smokers (P = 0.008). Spearman rank correlation test demonstrated a significant correlation between pack-years smoked and M-score in PCs (P = 0.039). Significant correlation of the M-score methylation was observed with high pT category (P < 0.001), high Gleason sum (P < 0.001), high preoperative prostate-specific antigen (PSA) (P = 0.041), and advanced pathologic features. In addition, Gleason sum was significantly associated with PSA failure-free probability as a poor outcome (P = 0.020). CONCLUSIONS This is the first study to demonstrate significant correlation of the methylation status of multigenes with smoking status in PC. Smoking status may influence both progression and prognosis of PC through CpG hypermethylation of related genes.
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Affiliation(s)
- Hideki Enokida
- Department of Urology, Veterans Affairs Medical Center and University of California, San Francisco, California 94121, USA
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Dennis LK, Ritchie JM, Resnick MI. Prostate cancer and consistency of reporting sexual histories in men over age 50. Prostate Cancer Prostatic Dis 2005; 8:243-7. [PMID: 15983628 DOI: 10.1038/sj.pcan.4500810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We conducted an in-person interview to examine the reliability of reported sexual histories among men over age 50 y with and without prostate cancer. Marriage and cohabitation were used as memory cues to recall sexual activity. High correlations on test-retest for questions evaluating sexual histories suggest reliable answers for most factors, and specifically for age at first sexual activity, and lifetime number of sexual partners. Low correlations were seen for ill-defined and socially undesirable items. These data suggest that men consistently report most measures of sexual activity when using marriage and cohabitation as memory cues to recall sexual histories.
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Affiliation(s)
- L K Dennis
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA.
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Mao GE, Morris G, Lu QY, Cao W, Reuter VE, Cordon-Cardo C, Dalbagni G, Scher HI, deKernion JB, Zhang ZF. Glutathione S-transferase P1 Ile105Val polymorphism, cigarette smoking and prostate cancer. ACTA ACUST UNITED AC 2005; 28:368-74. [PMID: 15542263 DOI: 10.1016/j.cdp.2004.07.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2004] [Accepted: 07/19/2004] [Indexed: 11/22/2022]
Abstract
The enzyme glutathione S-transferase P1 (GSTP1) detoxifies carcinogenic products of tobacco smoke. This exploratory case-control study evaluates the possible effect modification by the GSTP1 Ile105Val polymorphism (replacement of isoleucine by valine at codon 105) on smoking and prostate cancer. Because the Val variant possesses up to a five-fold greater enzymatic activity towards the carcinogenic metabolites of tobacco smoke, the Ile allele is expected to be related to an increase in the risk of prostate cancer among smokers. GSTP1 genotype and epidemiological data were obtained from 122 cases of prostate cancer and 135 healthy males as controls. A logistic regression model was used to estimate odds ratios and 95% confidence intervals. The adjusted OR of homozygous Ile compared to other genotypes for prostate cancer was 1.21 (95% CI: 0.61-2.83). Smoking was not significantly associated with prostate cancer with an adjusted OR of 1.56 (95% CI: 0.78-3.12). However, among individuals with the Ile/Ile genotype, smoking was strongly associated with an increased risk of prostate cancer with an adjusted odds ratio of 4.09 (95% CI: 1.25-13.35). A potential multiplicative interaction was suggested between GSTP1 and smoking on the risk of prostate cancer with the adjusted OR for the interaction of 4.52 (95% CI: 1.07-19.17). To our knowledge, this is the first time that a potential effect modification by the GSTP1 Ile/Ile genotype on smoking and the risk of prostate cancer is suggested.
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Affiliation(s)
- Gloria E Mao
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA 90095, USA
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Patel DA, Bock CH, Schwartz K, Wenzlaff AS, Demers RY, Severson RK. Sexually transmitted diseases and other urogenital conditions as risk factors for prostate cancer: a case–control study in Wayne County, Michigan. Cancer Causes Control 2005; 16:263-73. [PMID: 15947878 DOI: 10.1007/s10552-004-3486-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Accepted: 09/20/2004] [Indexed: 11/29/2022]
Abstract
UNLABELLED OBJECTIVE To investigate associations between prostate cancer and sexually transmitted diseases (STDs), prostatitis, benign prostatic hyperplasia (BPH), and vasectomy in a population-based case-control study in Wayne County, Michigan, among African American and white men aged 50--74 years. METHODS Incident prostate cancer cases (n=700) from 1996--1998 were identified from the Metropolitan Detroit Cancer Surveillance System. Controls (n=604) were identified through random digit dialing and Medicare recipient lists, and frequency matched to cases on age and race. History of potential prostate cancer risk factors was ascertained through in-person interview. RESULTS Prostate cancer was not associated with STD or vasectomy history. History of prostatitis was associated with prostate cancer among all subjects (odds ratio [OR]=1.8, 95% confidence interval [CI]: 1.1, 2.9) and in African American men (OR=2.2, 95% CI: 1.1, 4.6). History of BPH was associated with prostate cancer among all subjects (OR=2.4, 95% CI: 1.8, 3.3); significant associations were observed in both African American (OR=2.7, 95% CI: 1.6, 4.4) and white (OR=2.3, 95% CI: 1.5, 3.4) men. CONCLUSIONS Among all subjects, prostate cancer was associated with prostatitis and BPH history, but not with STD or vasectomy history. Prevention efforts could be enhanced if inflammatory or infectious etiologies are found to be of importance in the subsequent development of prostate cancer.
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Affiliation(s)
- Divya A Patel
- Karmanos Cancer Institute, Wayne State University, Detroit, MI 48109-0276, USA.
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Lightfoot N, Conlon M, Kreiger N, Sass-Kortsak A, Purdham J, Darlington G. Medical history, sexual, and maturational factors and prostate cancer risk. Ann Epidemiol 2004; 14:655-62. [PMID: 15380796 DOI: 10.1016/j.annepidem.2003.11.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2002] [Accepted: 11/03/2003] [Indexed: 10/26/2022]
Abstract
PURPOSE Sexual, physical, and medical factors were investigated in a case-control study of prostate cancer. METHODS This population-based study, conducted from 1995 to 1999 in northeastern Ontario, used cancer registry-identified cases (n=760), aged 45 to 84 years, diagnosed between 1995 and 1998. Age-frequency matched controls (n=1632) were obtained from telephone listings. Two separate logistic regression analyses considered: 1) sexual and physical; and 2) medical factors. RESULTS For the sexual-physical model, marital status, family income, maximum height, number of marriages, having children, age at first marriage, birth, and needing to shave, and acne were not significantly related to risk. In the medical model, a family history of prostate cancer (OR, 2.99; 95% CI, 2.21-4.04) and history of venereal disease (OR, 2.12; 95% CI, 1.27-3.53) were associated with significantly increased risk. A history of allergies (OR, 0.78; 95% CI, 0.60-1.00), benign prostatic hyperplasia (OR, 0.63; 95% CI, 0.49-0.81), and an annual physical exam (OR, 0.43; 95% CI, 0.21-0.85) were associated with reduced risk. Other factors considered in the medical conditions model, body mass index, smoking non-filter cigarettes, and family income were not associated with prostate cancer. CONCLUSIONS This study is consistent with other studies that suggest that infectious agents may be involved in prostate cancer development.
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Affiliation(s)
- Nancy Lightfoot
- Epidemiology Research Unit, Northeastern Ontario Regional Cancer Centre, Sudbury, Ontario, Canada.
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Abstract
BACKGROUND The association of infection or inflammation of the prostate with prostate cancer has been suggested but not established. This study was undertaken to investigate this association. METHODS Cases were Olmsted County, Minnesota, residents with histologically proven prostate cancer diagnosed between January 1980 and December 1996. Cases (n = 409) were each matched to 2 control subjects (n = 803) on age at diagnosis of prostate cancer, residency in Olmsted County, and duration of the community medical record. The medical record of each subject was reviewed for a history of acute or chronic bacterial prostatitis or chronic pelvic pain syndrome (inflammatory type). RESULTS The relative odds of prostate cancer were elevated in men with history of any type of prostatitis (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.1-2.6) or acute prostatitis (2.5; 1.3-4.7). The mean time from most recent episode of acute prostatitis to the diagnosis of prostate cancer was 12.2 years. After exclusion of men with acute prostatitis 2 years before the index date, the relationship was somewhat reduced (1.9; 0.9-3.8). Chronic bacterial prostatitis was more weakly associated with prostate cancer (1.6; 0.8-3.1), whereas chronic pelvic pain syndrome was not associated at all (0.9; 0.4-1.8). CONCLUSIONS Infection in the form of acute or chronic bacterial prostatitis may be associated with prostate cancer. However, our data do not provide compelling evidence to support this. As a result of the limitations of current methods of assessing chronic prostatitis, biochemical or tissue markers of infection or inflammation of the prostate may help clarify their role in the pathogenesis of prostate cancer.
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Affiliation(s)
- Rosebud O Roberts
- Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Bostwick DG, Burke HB, Djakiew D, Euling S, Ho SM, Landolph J, Morrison H, Sonawane B, Shifflett T, Waters DJ, Timms B. Human prostate cancer risk factors. Cancer 2004; 101:2371-490. [PMID: 15495199 DOI: 10.1002/cncr.20408] [Citation(s) in RCA: 383] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prostate cancer has the highest prevalence of any nonskin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating androgens will develop microscopic prostate cancer if they live long enough. This review is a contemporary and comprehensive, literature-based analysis of the putative risk factors for human prostate cancer, and the results were presented at a multidisciplinary consensus conference held in Crystal City, Virginia, in the fall of 2002. The objectives were to evaluate known environmental factors and mechanisms of prostatic carcinogenesis and to identify existing data gaps and future research needs. The review is divided into four sections, including 1) epidemiology (endogenous factors [family history, hormones, race, aging and oxidative stress] and exogenous factors [diet, environmental agents, occupation and other factors, including lifestyle factors]); 2) animal and cell culture models for prediction of human risk (rodent models, transgenic models, mouse reconstitution models, severe combined immunodeficiency syndrome mouse models, canine models, xenograft models, and cell culture models); 3) biomarkers in prostate cancer, most of which have been tested only as predictive factors for patient outcome after treatment rather than as risk factors; and 4) genotoxic and nongenotoxic mechanisms of carcinogenesis. The authors conclude that most of the data regarding risk relies, of necessity, on epidemiologic studies, but animal and cell culture models offer promise in confirming some important findings. The current understanding of biomarkers of disease and risk factors is limited. An understanding of the risk factors for prostate cancer has practical importance for public health research and policy, genetic and nutritional education and chemoprevention, and prevention strategies.
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Giles GG, Severi G, English DR, McCredie MRE, Borland R, Boyle P, Hopper JL. Sexual factors and prostate cancer. BJU Int 2003; 92:211-6. [PMID: 12887469 DOI: 10.1046/j.1464-410x.2003.04319.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess whether prostate cancer might be related to hormone levels and, by inference, to differences in sexual activity. PATIENTS, SUBJECTS AND METHODS In a case-control study of men with prostate cancer aged < 70 years at diagnosis and age-matched control subjects, information was collected on two aspects of sexual activity; the number of sexual partners and the frequency of total ejaculations during the third to fifth decades of life. RESULTS There was no association of prostate cancer with the number of sexual partners or with the maximum number of ejaculations in 24 h. There was a negative trend (P < 0.01) for the association between risk and number of ejaculations in the third decade, independent of those in the fourth or fifth. Men who averaged five or more ejaculations weekly in their 20s had an odds ratio (95% confidence interval) of 0.66 (0.49-0.87) compared with those who ejaculated less often. CONCLUSIONS The null association with the number of sexual partners argues against infection as a cause of prostate cancer in this population. Ejaculatory frequency, especially in early adult life, is negatively associated with the risk of prostate cancer, and thus the molecular biological consequences of suppressed or diminished ejaculation are worthy of further research.
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Affiliation(s)
- G G Giles
- Cancer Epidemiology Centre, and Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Melbourne, Australia.
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Dennis LK, Dawson DV, Resnick MI. Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy. Prostate Cancer Prostatic Dis 2003; 5:193-203. [PMID: 12496981 DOI: 10.1038/sj.pcan.4500586] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2001] [Accepted: 03/27/2002] [Indexed: 01/03/2023]
Abstract
The aim of this study was to conduct a quantitative review of prostate cancer studies to pool relative risk (RR) estimates on the association between prostate cancer and vasectomy, in an attempt to determine whether there is an association, and if so, its magnitude. Random-effects models were examined along with a linear model for time since vasectomy. The pooled RR estimate was 1.37 (95% CI=1.15-1.62) based on five cohort studies and 17 case-control studies. The RR estimate varied by study design with the lowest risk for population-based case-control studies. No difference was seen in risk by age at vasectomy. A linear trend based on the 16 studies reporting time since vasectomy suggested an 10% increase for each additional 10 y or a RR of 1.32 (95% CI=1.17-1.50) for 30 y since vasectomy. When null effects were assumed for the six studies not reporting information, the linear RR for the 22 studies was 1.07 (1.03-1.11) and 1.23 (1.11-1.37) for 10 and 30 y since vasectomy, respectively. These results suggest that men with a prior vasectomy may be at an increased risk of prostate cancer, however, the increase may not be causal since potential bias cannot be discounted. The overall association was small and therefore could be explained by bias. The latency effect shown here for time since vasectomy should be examined further.
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Affiliation(s)
- L K Dennis
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA.
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Giles GG, Severi G, English DR, McCredie MRE, MacInnis R, Boyle P, Hopper JL. Early growth, adult body size and prostate cancer risk. Int J Cancer 2003; 103:241-5. [PMID: 12455039 DOI: 10.1002/ijc.10810] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The role of growth from birth through puberty and through adult life has been the subject of epidemiologic investigation in regard to the risk of prostate cancer but the evidence remains weak and inconsistent. We investigated associations between prostate cancer risk and a number of markers of body growth, size and changes to size in a population-based, case-control study in Australia from 1994 to 1998. We analyzed data obtained in face-to-face interviews from 1,476 cases and 1,409 controls. The main outcomes of interest were the timing of the growth spurt in adolescence, the experience of acne and interviewer observation of facial acne scarring, body size at age 21, body size in reference year, maximum body weight and rate of body size change since age 21 years. Analysis was performed on all cases and also by tumour grade. We found no associations with measures of body size including body mass index and lean body mass at age 21 or later in adult life. Having a growth spurt later than friends reduced risk (odds ratio [OR] 0.79 [0.63-0.97]) and some measures of acne also gave odds ratios less than 1, for example, having facial acne scarring gave an OR of 0.67 (0.45-1.00). We conclude that markers of delayed androgen action, such as delayed growth spurt in puberty, and markers of other androgen-dependent activity in puberty, such as facial acne scarring, are associated with prostate cancer risk but we could detect no associations with markers of adult body size and growth including lean body mass.
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Affiliation(s)
- Graham G Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria, Australia.
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Fleshner N. Effects of Smoking, Alcohol, Exercise and Sun Exposure on Prostate Cancer. Prostate Cancer 2003. [DOI: 10.1016/b978-012286981-5/50024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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