"Prostate cancer is the most common cancer among men in western countries, and the second leading cause of cancer-specific mortality," lead author Jennifer R. Stark, ScD, from the Harvard School of Public Health in Boston, Massachusetts, said in a news release. "Identifying modifiable risk factors for the lethal form of prostate cancer offers the greatest opportunity to reduce suffering from this disease."
The present case-control study nested within the Physicians ' Health Study included 673 participants with prostate cancer and 673 individually matched control participants who had plasma samples available for testing. Using an enzyme-linked immunosorbent assay, the investigators tested plasma from blood samples collected at baseline for antibodies against T vaginalis. Odds ratios (ORs) of incident prostate cancer, extraprostatic prostate cancer, and cancer that would ultimately result in bony metastases or prostate cancer–related death were estimated with conditional logistic regression.
The magnitude of the association between T vaginalis–seropositive status and overall prostate cancer risk was similar to that reported previously but was not statistically significant (OR, 1.23; 95% confidence interval [CI], 0.94 – 1.61). Seropositive status was statistically significantly associated with increased risks for extraprostatic prostate cancer (OR, 2.17; 95% CI, 1.08 – 4.37) and for cancer that would ultimately result in bony metastases or death from prostate cancer (OR, 2.69; 95% CI, 1.37 – 5.28).
"The fact that we found a strong association between serologic evidence of infection with Trichomonas vaginalis, a potentially modifiable risk factor, and risk of advanced and lethal disease represents a step forward in prostate cancer, especially given that so few risk factors for aggressive prostate cancer have been identified," said senior author Lorelei Mucci, PhD, also from the Harvard School of Public Health.
Limitations of this study include an unknown period of time between infection and blood collection, which could affect assay sensitivity; concerns regarding reverse causation; and possible detection bias.
"This large prospective case–control study obtained further support for an association between a seropositive status for antibodies against T. vaginalis and the risk of prostate cancer, with statistically significant associations identified for the risk of extraprostatic prostate cancer and for clinically relevant, potentially lethal prostate cancer," the study authors write. "In light of the limited understanding of factors that lead to lethal prostate cancer, our finding of an association between T. vaginalis serostatus and aggressive prostate cancer is noteworthy. If our findings are confirmed, T. vaginalis could serve as a marker for adverse outcomes in patients for prostate cancer or, more optimistically, as a target for secondary chemoprevention."
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