Abstract
This nationwide population-based retrospective cohort study evaluated the risk of developing prostate cancer among patients with gonorrhea. We identified cases of newly diagnosed gonorrhea in men between 2000 and 2010 from the Taiwan National Health Insurance Research Database. Each patient with gonorrhea was matched to four controls, based on age and index year. All subjects were followed up from the index date to December 31, 2010. The Cox proportional hazards regression model was used to assess the risk of prostate cancer. A total of 355 men were included in the study group, and 1,420 age-matched subjects without gonorrhea were included in the control group. After adjusting for age, comorbidities, urbanization level, hospital level, and monthly income, gonorrhea was significantly associated with an increased risk of prostate cancer (adjusted hazard ratio = 5.66, 95% confidence interval = 1.36–23.52). Men aged 45–70 years and those with lower monthly income were more strongly associated with prostate cancer in the study group than the control group. The higher risk for developing prostate cancer were also found in those without syphilis, without genital warts, without diabetes mellitus, without chronic obstructive pulmonary disease, without benign prostatic hypertrophy, without chronic prostatitis, and without alcoholism. The Kaplan–Meier analysis showed the risk of prostate cancer was significantly higher in the study group than in the control group. Gonorrhea may be involved in the development of prostate cancer. More intensive screening and prevention interventions for prostate cancer should be recommended in men with gonorrhea.
Similar content being viewed by others
Abbreviations
- STI:
-
Sexually transmitted infection
- NHIRD:
-
National Health Insurance Research Database
- NHI:
-
National Health Insurance
- LHID2000:
-
Registry for Longitudinal Health Insurance Database 2000
- ICD-9-CM:
-
International Classification of Diseases, Ninth Revision, Clinical Modification
- HIV:
-
Human immunodeficiency virus
- DM:
-
Diabetes mellitus
- COPD:
-
Chronic obstructive pulmonary disease
- BPH:
-
Benign prostatic hypertrophy
- NTD:
-
New Taiwan dollars
- HR:
-
Hazard ratio
- CI:
-
Confidence interval
- PYs:
-
Person-years
- SPSS:
-
Statistical product and service Solutions
- SD:
-
Standard deviation
References
Bolan GA, Sparling PF, Wasserheit JN (2012) The emerging threat of untreatable gonococcal infection. N Engl J Med 366(6):485–487. doi:10.1056/NEJMp1112456
Unemo M, Ison CA, Cole M, Spiteri G, van de Laar M, Khotenashvili L (2013) Gonorrhoea and gonococcal antimicrobial resistance surveillance networks in the WHO European Region, including the independent countries of the former Soviet Union. Sex Transm Infect 89(Suppl 4):iv42–iv46. doi:10.1136/sextrans-2012-050909
Cheng CW, Li LH, Su CY, Li SY, Yen MY (2014) Changes in the six most common sequence types of Neisseria gonorrhoeae, including ST4378, identified by surveillance of antimicrobial resistance in northern Taiwan from 2006 to 2013. J Microbiol Immunol Infect 49(5):708–716. doi:10.1016/j.jmii.2014.08.016
Kidd S, Workowski KA (2015) Management of gonorrhea in adolescents and adults in the United States. Clin Infect Dis 61(Suppl 8):S785–S801. doi:10.1093/cid/civ731
Belkacem A, Caumes E, Ouanich J, Jarlier V, Dellion S, Cazenave B, Goursaud R, Lacassin F, Breuil J, Patey O (2013) Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009–2011. Sex Transm Infect 89(8):613–615. doi:10.1136/sextrans-2013-051119
Baade PD, Youlden DR, Krnjacki LJ (2009) International epidemiology of prostate cancer: geographical distribution and secular trends. Mol Nutr Food Res 53(2):171–184. doi:10.1002/mnfr.200700511
Baade PD, Youlden DR, Cramb SM, Dunn J, Gardiner RA (2013) Epidemiology of prostate cancer in the Asia-Pacific region. Prostate Int 1(2):47–58. doi:10.12954/pi.12014
Hiatt RA, Armstrong MA, Klatsky AL, Sidney S (1994) Alcohol consumption, smoking, and other risk factors and prostate cancer in a large health plan cohort in California (United States). Cancer Causes Control CCC 5(1):66–72
Hayes BD, Brady L, Pollak MN, Finn S (2016) Exercise and prostate cancer: evidence and proposed mechanisms for disease modification. Cancer Epidemiol Biomark Prev 25(9):1281–1288. doi:10.1158/1055-9965.epi-16-0223
Taylor ML, Mainous AG 3rd, Wells BJ (2005) Prostate cancer and sexually transmitted diseases: a meta-analysis. Fam Med 37(7):506–512
Caini S, Gandini S, Dudas M, Bremer V, Severi E, Gherasim A (2014) Sexually transmitted infections and prostate cancer risk: a systematic review and meta-analysis. Cancer Epidemiol 38(4):329–338. doi:10.1016/j.canep.2014.06.002
Sutcliffe S, Giovannucci E, De Marzo AM, Leitzmann MF, Willett WC, Platz EA (2006) Gonorrhea, syphilis, clinical prostatitis, and the risk of prostate cancer. Cancer Epidemiol Biomark Prev 15(11):2160–2166. doi:10.1158/1055-9965.epi-05-0913
Spence AR, Rousseau MC, Parent ME (2014) Sexual partners, sexually transmitted infections, and prostate cancer risk. Cancer Epidemiol 38(6):700–707. doi:10.1016/j.canep.2014.09.005
Cheng I, Witte JS, Jacobsen SJ, Haque R, Quinn VP, Quesenberry CP, Caan BJ, Van Den Eeden SK (2010) Prostatitis, sexually transmitted diseases, and prostate cancer: the California Men’s Health Study. PLoS One 5(1), e8736. doi:10.1371/journal.pone.0008736
Mishina T, Watanabe H, Araki H, Nakao M (1985) Epidemiological study of prostatic cancer by matched-pair analysis. Prostate 6(4):423–436
Oishi K, Okada K, Yoshida O, Yamabe H, Ohno Y, Hayes RB, Schroeder FH (1989) Case–control study of prostatic cancer in Kyoto, Japan: demographic and some lifestyle risk factors. Prostate 14(2):117–122
Hrbacek J, Urban M, Hamsikova E, Tachezy R, Eis V, Brabec M, Heracek J (2011) Serum antibodies against genitourinary infectious agents in prostate cancer and benign prostate hyperplasia patients: a case–control study. BMC Cancer 11(1):1–10. doi:10.1186/1471-2407-11-53
Chang CY, Chen WL, Liou YF, Ke CC, Lee HC, Huang HL, Ciou LP, Chou CC, Yang MC, Ho SY, Lin YR (2014) Increased risk of major depression in the three years following a femoral neck fracture--a national population-based follow-up study. PLoS One 9(3), e89867. doi:10.1371/journal.pone.0089867
Wynder EL, Mabuchi K, Whitmore WF Jr (1971) Epidemiology of cancer of the prostate. Cancer 28(2):344–360
Chung SD, Lin YK, Huang CC, Lin HC (2013) Increased risk of prostate cancer following sexually transmitted infection in an Asian population. Epidemiol Infect 141(12):2663–2670. doi:10.1017/s0950268813000459
Sutcliffe S (2010) Sexually transmitted infections and risk of prostate cancer: review of historical and emerging hypotheses. Future Oncol 6(8):1289–1311. doi:10.2217/fon.10.95
Heshmat MY, Kovi J, Herson J, Jones GW, Jackson MA (1975) Epidemiologic association between gonorrhea and prostatic carcinoma. Urology 6(4):457–460
Haverkamp J, Charbonneau B, Ratliff TL (2008) Prostate inflammation and its potential impact on prostate cancer: a current review. J Cell Biochem 103(5):1344–1353. doi:10.1002/jcb.21536
Silberstein J, Downs T, Lakin C, Kane CJ (2009) HIV and prostate cancer: a systematic review of the literature. Prostate Cancer Prostatic Dis 12(1):6–12. doi:10.1038/pcan.2008.44
Stangelberger A, Waldert M, Djavan B (2008) Prostate cancer in elderly men. Rev Urol 10(2):111–119
Liu L, Cozen W, Bernstein L, Ross RK, Deapen D (2001) Changing relationship between socioeconomic status and prostate cancer incidence. J Natl Cancer Inst 93(9):705–709
Mackillop WJ, Zhang-Salomons J, Boyd CJ, Groome PA (2000) Associations between community income and cancer incidence in Canada and the United States. Cancer 89(4):901–912
Krieger N, Quesenberry C Jr, Peng T, Horn-Ross P, Stewart S, Brown S, Swallen K, Guillermo T, Suh D, Alvarez-Martinez L, Ward F (1999) Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic, and White residents of the San Francisco Bay Area, 1988–92 (United States). Cancer Causes Control CCC 10(6):525–537
Howe HL, Wu X, Ries LA, Cokkinides V, Ahmed F, Jemal A, Miller B, Williams M, Ward E, Wingo PA, Ramirez A, Edwards BK (2006) Annual report to the nation on the status of cancer, 1975–2003, featuring cancer among U.S. Hispanic/Latino populations. Cancer 107(8):1711–1742. doi:10.1002/cncr.22193
Cornman JC, Glei DA, Goldman N, Ryff CD, Weinstein M (2015) Socioeconomic status and biological markers of health: an examination of adults in the United States and Taiwan. J Aging Health 27(1):75–102. doi:10.1177/0898264314538661
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Funding
This study was supported in part by grants from Tri-Service General Hospital (TSGH-C104-117, TSGH-C105-112); Armed Forces Tao-Yuan General Hospital (AFTYGH-10501); and the Ministry of Science and Technology (MOST-104-2314-B-016-022, MOST-105-2314-B-016-039-MY3).
Conflict of interest
None declared.
Ethical approval
This study was approved by the Institutional Review Board of Tri-Service General Hospital (TSGHIRB-B-104-21).
Informed consent
All patient identity data were scrambled cryptographically in this study.
Additional information
W.-C. Chien and S.-T. Shang contributed equally to this work.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary Figure 1
(DOC 47 kb)
Rights and permissions
About this article
Cite this article
Wang, YC., Chung, CH., Chen, JH. et al. Gonorrhea infection increases the risk of prostate cancer in Asian population: a nationwide population-based cohort study. Eur J Clin Microbiol Infect Dis 36, 813–821 (2017). https://doi.org/10.1007/s10096-016-2866-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-016-2866-7