Prospective Study of Trichomonas vaginalis Infection and Prostate Cancer Incidence and Mortality: Physicians' Health Study

Jennifer R. Stark; Gregory Judson; John F. Alderete; Vasanthakrishna Mundodi; Ashwini S. Kucknoor; Edward L. Giovannucci; Elizabeth A. Platz; Siobhan Sutcliffe; Katja Fall; Tobias Kurth; Jing Ma; Meir J. Stampfer; Lorelei A. Mucci


J Natl Cancer Inst. 2009;101(20):1406-11. 

In This Article


On average, case subjects were aged 68.7 years (SD = ±7.4 years) at diagnosis. Most case subjects were diagnosed with well-differentiated tumors (54% with a Gleason score of 2–6) at a localized stage (83% with a stage of T1 or T2). Mean time between blood collection and prostate cancer diagnosis was 9.3 years (range = 0.3–17.9 years). The seroprevalence of T vaginalis infection was 21% in control subjects and 25% in case subjects (Table 1). T vaginalis absorbance scores were not associated with age or baseline prostate-specific antigen (PSA) levels in case subjects or control subjects.

T vaginalis seropositivity was not statistically significantly associated with total prostate cancer risk (OR = 1.23, 95% CI = 0.94 to 1.61) or high-grade disease (OR for Gleason 7–10 scores = 1.10, 95% CI = 0.72 to 1.68). However, serological evidence of T vaginalis infection was associated with a statistically significant increase in the risk of diagnosis of advanced-stage prostate cancer (OR = 2.17, 95% CI = 1.08 to 4.37) and in the risk of cancer that would ultimately progress to distant metastases or cancer-specific death (OR = 2.69, 95% CI = 1.37 to 5.28) (Table 1). We also found that the association between T vaginalis and prostate cancer was stronger for men who were diagnosed more closely to blood collection (Table 1). Compared with case subjects overall (n = 673), the 94 case subjects who were diagnosed within 5 years of blood collection tended to be somewhat older at diagnosis (eg, those who were aged >65 years = 72 [77%] vs 452 [67%]) and more advanced (eg, those who were at stage T3 or T4, N1, or M1 = 23 [25%] vs 105 [16%]). However, cross-classifying men on these characteristics suggested that the time scale that most influenced effect estimates was the duration between blood collection and diagnosis. Given the observed increased risk for cancer soon after blood collection, we explored the association between T vaginalis serostatus and lethal prostate cancer, according to years from blood collection to diagnosis. Among the 39 men diagnosed with lethal cancer within 5 years of blood collection and their matched control subjects, men positive for history of trichomonosis (n = 15) were statistically significantly more likely to develop lethal prostate cancer than seronegative men (OR = 6.4, 95% CI = 1.5 to 27.9).


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