Prostate cancer and sexually transmitted diseases: a meta-analysis.

BACKGROUND Prostate cancer is the most common neoplasm of American men and the second most common cause of cancer-related deaths. Research suggests that infection and subsequent inflammation may be an important risk factor in the pathogenesis of prostate cancer. In this meta-analysis, we examine the current epidemiological evidence for the association between specific sexually transmitted diseases (STDs) and prostate cancer. METHODS Using an English language search of Medline and CINAHL (Cumulative Index to Nursing and Allied Health) since 1966, 29 case-control studies were identified. These studies included a total of 6,022 cases of prostate cancer and 7,320 controls. Using Review Manager, combined odds ratios (ORs) were calculated for any STDs, gonorrhea, syphilis, and human papillomavirus (HPV) for prostate cancer. RESULTS Significant elevated ORs for prostate cancer were demonstrated for any STDs (1.48, 95% confidence interval [CI] 1.26-1.73), gonorrhea (1.35, 95% CI 1.05-1.83), and human papillomavirus (1.39, 95% CI 1.12-2.06). CONCLUSIONS This meta-analysis provides evidence of a higher rate of prostate cancer in men with a history of an exposure to gonorrhea, HPV, or any STD. Further research, especially with cohort studies, is required to confirm this potentially modifiable risk factor.