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Abstract
ObjectivesTo investigate the association between lower urinary-tract infections, their associated antibiotics and the subsequent risk of developing PCa.Subjects/Patients (or materials) and methodsUsing data from the Swedish PCBaSe 3.0, we performed a matched case-control study (8762 cases and 43806 controls). Conditional logistic regression analysis was used to assess the association between lower urinary-tract infections, related antibiotics and PCa, whilst adjusting for civil status, education, Charlson Comorbidity Index and time between lower urinary-tract infection and PCa diagnosis.ResultsIt was found that lower urinary-tract infections did not affect PCa risk, however, having a lower urinary-tract infection or a first antibiotic prescription 6–12 months before PCa were both associated with an increased risk of PCa (OR: 1.50, 95% CI: 1.23–1.82 and 1.96, 1.71–2.25, respectively), as compared to men without lower urinary-tract infections. Compared to men with no prescriptions for antibiotics, men who were prescribed ≥10 antibiotics, were 15% less likely to develop PCa (OR: 0.85, 95% CI: 0.78–0.91).ConclusionPCa was not found to be associated with diagnosis of a urinary-tract infection or frequency, but was positively associated with short time since diagnoses of lower urinary-tract infection or receiving prescriptions for antibiotics. These observations can likely be explained by detection bias, which highlights the importance of data on the diagnostic work-up when studying potential risk factors for PCa.
Highlights
Inflammation caused by infectious agents or environmental conditions has been put forward as a possible cause for an increased prostate cancer (PCa) risk
It was found that lower urinary-tract infections did not affect PCa risk, having a lower urinary-tract infection or a first antibiotic prescription 6–12 months before PCa were both associated with an increased risk of PCa (OR: 1.50, 95% CI: 1.23–1.82 and 1.96, 1.71–2.25, respectively), as compared to men without lower urinary-tract infections
Compared to men with no prescriptions for antibiotics, men who were prescribed !10 antibiotics, were 15% less likely to develop PCa (OR: 0.85, 95% CI: 0.78–0.91)
Summary
Inflammation caused by infectious agents or environmental conditions has been put forward as a possible cause for an increased prostate cancer (PCa) risk. The microorganism Escherichia coli has been identified as being the major pathogen involved in lower urinary-tract infection and is believed to account for around 80% of all urinary tract infections [3,4]. It has not yet been proven to be carcinogenic. Inflammation of the prostate gland (prostatitis) is known to be attributed by infection of the microorganisms that are causative of lower urinary tract infections (LUTIs). With a link between the infectious agents, inflammation and the location of the prostate gland, a potential association between lower urinary-tract infections and PCa may be conceived [5]
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