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Sexually transmitted infections, benign prostatic hyperplasia and lower urinary tract symptom-related outcomes: results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.
BJU Int. 2016 Jan; 117(1):145-54.BI

Abstract

OBJECTIVE

To examine whether a history of sexually transmitted infections (STIs) or positive STI serology is associated with prevalent and incident benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS)-related outcomes in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

METHODS

Self-reported history of STIs (gonorrhoea, syphilis) was ascertained at baseline, and serological evidence of STIs (Chlamydia trachomatis, Trichomonas vaginalis, human papillomavirus (HPV)-16, HPV-18, herpes simplex virus type 2, human herpesvirus type 8 and cytomegalovirus) was detected in baseline serum specimens. We used data collected on the baseline questionnaire, as well as results from the baseline prostate-specific antigen (PSA) test and digital rectal examination (DRE), to define prevalent BPH/LUTS-related outcomes as evidence of LUTS (self-reported diagnosis of an enlarged prostate/BPH, BPH surgery or nocturia [waking ≥2 times/night to urinate]) and evidence of prostate enlargement (PSA > 1.4 ng/mL or prostate volume ≥30 mL) in men without prostate cancer. We created a similar definition of incident BPH using data from the follow-up questionnaire completed 5-13 years after enrolment (self-reported diagnosis of an enlarged prostate/BPH or nocturia), data on finasteride use during follow-up, and results from the follow-up PSA tests and DREs. We used Poisson regression with robust variance estimation to calculate prevalence ratios (PRs) in our cross-sectional analysis of self-reported (n = 32 900) and serologically detected STIs (n = 1 143) with prevalent BPH/LUTS, and risk ratios in our prospective analysis of self-reported STIs with incident BPH/LUTS (n = 5 226).

RESULTS

Generally null results were observed for associations of a self-reported history of STIs and positive STI serologies with prevalent and incident BPH/LUTS-related outcomes, with the possible exception of T. vaginalis infection. This STI was positively associated with prevalent nocturia (PR 1.36, 95% confidence interval (CI) 1.18-1.65), prevalent large prostate volume (PR 1.21 95% CI 1.02-1.43), and any prevalent BPH/LUTS (PR 1.32 95% CI 1.09-1.61); too few men had information on both STI serologies and incident BPH/LUTS to investigate the associations between T. vaginalis infection and incident BPH/LUTS-related outcomes.

CONCLUSIONS

Our findings do not support associations of several known STIs with BPH/LUTS-related outcomes, although T. vaginalis infection may warrant further study.

Authors+Show Affiliations

Department of Urology, University of California San Francisco, San Francisco, CA, USA.Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, MD, USA.Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, MD, USA.School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA.Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.Department of Urology, University of California San Francisco, San Francisco, CA, USA.Information Management Services, Rockville, MD, USA.Westat, Rockville, MD, USA.Coeus Health, Chicago, IL, USA.Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25601300

Citation

Breyer, Benjamin N., et al. "Sexually Transmitted Infections, Benign Prostatic Hyperplasia and Lower Urinary Tract Symptom-related Outcomes: Results From the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial." BJU International, vol. 117, no. 1, 2016, pp. 145-54.
Breyer BN, Huang WY, Rabkin CS, et al. Sexually transmitted infections, benign prostatic hyperplasia and lower urinary tract symptom-related outcomes: results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. BJU Int. 2016;117(1):145-54.
Breyer, B. N., Huang, W. Y., Rabkin, C. S., Alderete, J. F., Pakpahan, R., Beason, T. S., Kenfield, S. A., Mabie, J., Ragard, L., Wolin, K. Y., Grubb, R. L., Andriole, G. L., & Sutcliffe, S. (2016). Sexually transmitted infections, benign prostatic hyperplasia and lower urinary tract symptom-related outcomes: results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. BJU International, 117(1), 145-54. https://doi.org/10.1111/bju.13050
Breyer BN, et al. Sexually Transmitted Infections, Benign Prostatic Hyperplasia and Lower Urinary Tract Symptom-related Outcomes: Results From the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. BJU Int. 2016;117(1):145-54. PubMed PMID: 25601300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexually transmitted infections, benign prostatic hyperplasia and lower urinary tract symptom-related outcomes: results from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. AU - Breyer,Benjamin N, AU - Huang,Wen-Yi, AU - Rabkin,Charles S, AU - Alderete,John F, AU - Pakpahan,Ratna, AU - Beason,Tracey S, AU - Kenfield,Stacey A, AU - Mabie,Jerome, AU - Ragard,Lawrence, AU - Wolin,Kathleen Y, AU - Grubb,Robert L,3rd AU - Andriole,Gerald L, AU - Sutcliffe,Siobhan, Y1 - 2015/04/23/ PY - 2015/1/21/entrez PY - 2015/1/21/pubmed PY - 2016/4/26/medline KW - Prostate lung colorectal and ovarian cancer screening trial KW - benign prostatic hyperplasia KW - nocturia KW - sexually transmitted infection SP - 145 EP - 54 JF - BJU international JO - BJU Int. VL - 117 IS - 1 N2 - OBJECTIVE: To examine whether a history of sexually transmitted infections (STIs) or positive STI serology is associated with prevalent and incident benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS)-related outcomes in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. METHODS: Self-reported history of STIs (gonorrhoea, syphilis) was ascertained at baseline, and serological evidence of STIs (Chlamydia trachomatis, Trichomonas vaginalis, human papillomavirus (HPV)-16, HPV-18, herpes simplex virus type 2, human herpesvirus type 8 and cytomegalovirus) was detected in baseline serum specimens. We used data collected on the baseline questionnaire, as well as results from the baseline prostate-specific antigen (PSA) test and digital rectal examination (DRE), to define prevalent BPH/LUTS-related outcomes as evidence of LUTS (self-reported diagnosis of an enlarged prostate/BPH, BPH surgery or nocturia [waking ≥2 times/night to urinate]) and evidence of prostate enlargement (PSA > 1.4 ng/mL or prostate volume ≥30 mL) in men without prostate cancer. We created a similar definition of incident BPH using data from the follow-up questionnaire completed 5-13 years after enrolment (self-reported diagnosis of an enlarged prostate/BPH or nocturia), data on finasteride use during follow-up, and results from the follow-up PSA tests and DREs. We used Poisson regression with robust variance estimation to calculate prevalence ratios (PRs) in our cross-sectional analysis of self-reported (n = 32 900) and serologically detected STIs (n = 1 143) with prevalent BPH/LUTS, and risk ratios in our prospective analysis of self-reported STIs with incident BPH/LUTS (n = 5 226). RESULTS: Generally null results were observed for associations of a self-reported history of STIs and positive STI serologies with prevalent and incident BPH/LUTS-related outcomes, with the possible exception of T. vaginalis infection. This STI was positively associated with prevalent nocturia (PR 1.36, 95% confidence interval (CI) 1.18-1.65), prevalent large prostate volume (PR 1.21 95% CI 1.02-1.43), and any prevalent BPH/LUTS (PR 1.32 95% CI 1.09-1.61); too few men had information on both STI serologies and incident BPH/LUTS to investigate the associations between T. vaginalis infection and incident BPH/LUTS-related outcomes. CONCLUSIONS: Our findings do not support associations of several known STIs with BPH/LUTS-related outcomes, although T. vaginalis infection may warrant further study. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/25601300/Sexually_transmitted_infections_benign_prostatic_hyperplasia_and_lower_urinary_tract_symptom_related_outcomes:_results_from_the_Prostate_Lung_Colorectal_and_Ovarian_Cancer_Screening_Trial_ L2 - https://doi.org/10.1111/bju.13050 DB - PRIME DP - Unbound Medicine ER -