Evaluation of oxidative balance scores using different methods and their relationships with colorectal cancer prognosis: A prospective cohort study.

Multiple concurrent sexual partnerships (MCP) may drive new HIV infections. We investigated the association between MCP and recent or incident HIV infection in a cluster-randomized HIV prevention trial that followed a population-based HIV incidence cohort across 30 communities in Botswana. We used structured questionnaires to evaluate MCP for prior 12 months, defined as either (1) MCP per UNAIDS definition or (2) concurrent sexual relationship per survey questions. Recent HIV infection was determined using an avidity assay-based algorithm or seroconversion within 2 years, and incident infection was determined through annual HIV testing for up to 3 years. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for MCP predictors using univariate and multivariable Poisson regression with log-link and fixed effects for matched pairs. We included 11,965 (94.9%) of the 12,610 participants in the Botswana Combination Prevention Project with sexual history data. Among 9363 sexually active persons in prior 12 months, 2770 (29.6%) were engaged in MCP. Factors independently associated with MCP included male sex (aPR = 1.57; 95% CI: 1.45 to 1.71), age < 25 years (aPR = 1.25, 95% CI: 1.01 to 1.56), alcohol consumption ≥ 2 times/week (aPR = 1.38, 95% CI: 1.26 to 1.51), transactional sex (aPR = 1.69, 95% CI: 1.49 to 1.92), having a partner with MCP (aPR = 1.82, 95% CI: 1.65 to 2.02), and intergenerational sex (partners 10 years younger: aPR = 1.16, 95% CI: 1.06 to 1.28 or 10 years older: aPR = 1.32, 95% CI: 1.15 to 1.51). Reporting prior MCP was associated with HIV seroconversion during follow-up (aPR= 1.28, 95% CI: 1.05 to 1.57) but not with prevalent or recent HIV infection at baseline. MCP was common and associated with incident HIV infection. People reporting MCP may benefit from pre-exposure prophylaxis.

As the impact of angiotensin receptor/neprilysin inhibitor (ARNI) on cardiac function in acute myocardial infarction (AMI) patients is unclear in clinical therapy, we conducted this research to investigate the actual effects of improving cardiac function with ARNI in AMI patients. Publications were checked up to June 2022. Standardised mean differences (SMD) and 95% confidence intervals (CI) were utilised for assessing the size of the effect of continuous variables. To assess the magnitude of the effect of dichotomous variables, a relative risk (RR) with 95% CI was used. ARNI could improve left ventricular ejection fraction (SMD = 0.40; 95% CI: 0.23 - 0.58), while lowering left ventricular end-diastolic volume (SMD = -0.43, 95% CI: -0.78 to -0.08), left ventricular end-systolic volume (SMD = -0.39, 95% CI: -0.66 to -0.11) and left ventricular enddiastolic diameter (SMD = -0.49; 95% CI: -0.65 to -0.33). Besides, it could decrease the rates of major adverse cardiac events (RR = 0.55; 95% CI: 0.43 - 0.69) and heart failure (RR = 0.42; 95% CI: 0.31 - 0.58). ARNI could greatly improve cardiac function in AMI patients.

Clinical Characteristics and Prognosis of Acute Heart Failure in Patients with Chronic Obstructive Pulmonary Disease.

Heart failure is a major cause of global morbidity and mortality. Studies in laboratory animals have shown the direct protective effects of α-klotho on the cardiovascular system although it has limited expression in the heart. The association between α-klotho and cardiovascular disease is still controversial in different clinical studies. We designed a cross-sectional study in order to investigate the association between serum α-klotho level and the prevalence of heart failure in the American general population. The data were obtained from the National Health and Nutrition Examination Survey (NHANES), which included 11 271 participants aged 40-80 years. Serum α-klotho level was examined by enzyme-linked immunosorbent assay and divided into four quartiles for further analysis. Heart failure status was obtained from self-reported questionnaires. To estimate the association between α-klotho level and prevalence of heart failure, multivariate logistic regression analyses were conducted. Interaction and stratified analyses were performed to evaluate the potential modifiers. After adjusting for multiple covariates, a per-standard deviation increase in serum α-klotho level was associated with a decrease in prevalence of heart failure [odds ratio (OR): 0.76, 95% confidence interval (CI): 0.68-0.85). The ORs for participants in quartiles 2 to 4 were 0.77 (95% CI: 0.58-1.01), 0.70 (95% CI: 0.52-0.93) and 0.71 (95% CI: 0.53-0.95), respectively, compared with those in quartile 1. Stratified analysis revealed significant gender and racial differences. We revealed an independent association between serum α-klotho level and the prevalence of heart failure in the American general population. The association was not always consistent and varied according to gender and race.

Fludarabine with melphalan (FM) or busulfan (FB) is among the most widely used reduced-intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The authors conducted a systematic review and meta-analysis comparing these regimens in adult patients with hematologic malignancies. A comprehensive search of Ovid MEDLINE, Embase, and the Cochrane Library from inception through July 22, 2025, identified 17 eligible studies involving 10,396 patients. Pooled analyses were performed using a random-effects model, and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. In the overall analysis, FM was associated with improved progression-free survival (PFS) (HR, 0.90; 95% CI, 0.82-0.98), driven by lower relapse rates (HR, 0.69; 95% CI, 0.62-0.78) but increased treatment-related mortality (TRM) (HR, 1.44; 95% CI, 1.10-1.89). There were no significant differences in overall survival (OS), grade 3-4 acute graft-versus-host disease (GVHD), or chronic GVHD. In subgroup analyses, FM significantly improved OS and PFS, primarily driven by a significant reduction in relapse risk in acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) and elderly patients aged ≥60 years without significant differences in TRM. In contrast, for lymphoma patients, FM was associated with worse OS and higher TRM compared with FB, and no advantage in PFS, but significantly lower relapse. These findings suggest that FM may be a preferred reduced-intensity regimen for AML/MDS and elderly patients, whereas lower intensity regimens may be needed for lymphoma to reduce TRM and optimize long-term survival after allo-HSCT.

Clinical outcomes in women and men with raphe-type bicuspid aortic valve stenosis undergoing transcatheter aortic valve replacement.

The Veterans Aging Cohort Study (VACS) Index 2.0 accurately predicts mortality using age and clinical biomarkers, but adding behavioral and psychosocial factors that are common among sexual minority men (SMM) may improve its predictive accuracy. We examined whether adding these factors would improve mortality prediction among SMM living with HIV. We included 1438 SMM in the Multicenter AIDS Cohort Study who initiated highly active antiretroviral therapy for at least 1 year between January 1996 and September 2022. We divided the sample into development (70%) and validation (30%) sets. We used Cox proportional hazards models to develop new indices in the development set by adding binary behavioral and psychosocial factors (depression, cigarette smoking, heavy alcohol use, polydrug use) or the total number of these factors in the VACS Index 2.0 and estimated mortality using Weibull survival models. We compared accuracy using C-statistics and calibration curves in the validation set and within subgroups (age, race, CD4 count, and viral suppression). Among the 1438 SMM, 83 (5.8%) died within 5 years of follow-up. Depression significantly predicted 5-year mortality after adjusting for the VACS Index 2.0 and resulted in a 70% increased risk of death (adjusted hazard ratio = 1.70, 95% confidence interval: 1.10 to 2.63) compared with men without depression. The addition of depression improved C-statistics from 0.818 to 0.851 in the development set. Results were robust in all subgroups. Including depression improved the VACS Index 2.0 in predicting mortality. Screening and treating depression could improve health and reduce mortality among SMM living with HIV.

The diagnostic and therapeutic efforts instituted by the state of Senegal since the results of the STEPwise survey in 2015 could and should be reinforced with an effective and targeted preventative approach against cardiovascular accidents. This study aimed to (1) identify the pathological population that contains the most incidents of stroke in Senegal, (2) identify the prevalence, and geographical and gender distribution of biological co-morbidities with hypertension, stroke and advice for a change in behaviour, and (3) research the factors associated with the occurrence of cardiovascular accidents specific to the Senegalese context. This was a secondary analysis of the STEPwise WHO Senegal 2015 survey: a descriptive quantitative epidemiological study with an analytical aim. Biological co-morbidities with arterial hypertension as well as cardiovascular accidents affected more women than men. Biological co-morbidities with arterial hypertension predominated in urban areas, while cardiovascular accidents were more common in rural areas. The population with arterial hypertension and total hypercholesterolaemia simultaneously was at the top of a list of 25 pathological populations in terms of the proportion of cardiovascular accidents within them. In addition, total hypercholesterolaemia was found in the first three populations with the most cardiovascular accidents. Regarding advice for behavioural change, advice for smoking cessation was the most widespread. All advice was given mostly to the gender most affected by the health problem, but some advice was mostly addressed to the environment least affected by the problem. Therefore, despite being the most affected, the rural environment received the least advice for a change in behaviour with regard to the practice of any of the forms of the physical activities described, the consumption of oil of palm, the consumption of cubed sugar or sugary drinks, smoked and non-smoked tobacco and attempted smoking cessation. In multivariate analysis, it was found that arterial hypertension produced a 2.74 times greater risk of having a cardiovascular accident (adjusted odds ratio = 2.74; 95% confidence interval = 1.88-3.99; p < 0.001). In Senegal, we need to pay more attention to arterial hypertension, dyslipidaemia, women and the rural environment in our ongoing fight against cardiovascular diseases and their risk factors.

Health-conscious behavior can help prevent cardiovascular diseases. The DECADE intervention ("decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases") is designed to support primary care physicians in cardiovascular risk counseling. We studied the effects of two of its components. A trial with a cluster-randomized 2 x 2 design was conducted in three regions of Germany (registration number DRKS00025401). 76 primary care physicians who were randomly allocated to one of four study arms recruited a total of 797 patients with lifestyle-related cardiovascular risk factors. 712 of them were included in the analysis. Cardiovascular risk was calculated for all patients at the start of the intervention and at 12 months. The control group (CG) underwent usual treatment; intervention group (IG) 1 received DECADE patient materials; IG2 had patient-centered DECADE follow-up consultations (at week 1, at months 3, 6, and 12; and additionally at month 9, if necessary); and IG3 received both of these DECADE intervention components. The primary endpoint was the self-reported change in patient activation (Patient Activation Measure, PAM13) at month 6. The secondary endpoints were changes in health behavior and clinical parameters. Linear mixed regression models were used to analyze the effects of DECADE follow-up consultations (IG2 + IG3) versus no follow-up consultations (CG + IG1), and of DECADE materials (IG1 + IG3) versus no materials (CG + IG2), according to the 2 x 2 design. DECADE follow-up consultations (compared to none) had a small positive, statistically significant effect on the primary endpoint PAM13 score of 1.14 points (95% confidence interval (CI): [0.09; 2.19], p = 0.033). The effect of DECADE patient materials (compared to none) was 0.30 (95% CI: [-0.75; 1.35], p = 0.57). Patients in all study arms showed improved health behavior. Although the demonstrated effect on the PAM13 score is of uncertain clinical relevance, other findings of this trial imply that DECADE may effectively support physicians in cardiovascular risk counseling. A long-term trial of its clinical effects is recommended.

Introduction: Premature rupture of membranes (PROM) is defined as the rupture of the amniotic sac before the onset of labor, potentially increasing the risk of infection, hypoxia, and a low APGAR score in newborns. The APGAR score assesses neonatal health immediately after birth and can be influenced by maternal and delivery factors, including PROM duration. Methods: This analytical observational study used a cross-sectional design involving 119 term pregnant women with PROM, selected through purposive sampling from medical records at Dr. H. Abdul Moeloek Regional General Hospital, Lampung Province, in 2024. The independent variable was PROM duration (&lt;12 hours or &gt;12 hours), and the dependent variable was the neonatal APGAR score (&gt;7 or &lt;7). Data analysis employed the Chi-square test with a 95% confidence level. Results: Most respondents (83.2%) experienced PROM lasting &lt;12 hours, and 79% of newborns had APGAR scores &gt;7. Chi-square analysis revealed no statistically significant association between PROM duration and APGAR score (p = 0.092; OR = 0.93). Although a higher proportion of low APGAR scores occurred in the &gt;12-hour PROM group, the relationship was insignificant. Conclusion: The study indicates no significant correlation between PROM duration in term pregnancies and neonatal APGAR scores. Prompt medical interventions may mitigate potential risks, reducing the impact of PROM duration on immediate neonatal outcomes. These findings highlight the importance of timely obstetric management and suggest further research with larger sample sizes to explore other contributing factors.

Introduction: Stunting remains a major public health concern in Indonesia, particularly in remote and highland regions such as the Bintang Mountains of Papua. It is characterized by impaired physical and cognitive development due to chronic malnutrition, repeated infections, and inadequate health services. Understanding the determinants of stunting in these settings is critical to inform effective interventions and policies. Methods: This study employed an analytical survey with a case-control design to examine risk factors associated with stunting among toddlers aged 24–59 months in the Oksibil Health Center working area, Bintang Mountains Regency, Papua. A total of 66 respondents were recruited between April and May 2024, consisting of 33 stunted toddlers (cases) and 33 non-stunted toddlers (controls). Data were collected through structured interviews and analyzed using odds ratios (ORs) with 95% confidence intervals to identify significant risk factors. Results: The findings revealed that several factors were significantly associated with stunting: maternal knowledge (OR = 1.911), history of infectious diseases (OR = 8.090), environmental sanitation (OR = 1.375), socio-cultural practices (OR = 3.801), and health service utilization (OR = 9.339). Among these, inadequate health service utilization posed the highest risk. Socio-cultural norms, poor hygiene practices, and limited maternal awareness were also strongly linked to stunting prevalence. Conclusion: Stunting in the Bintang Mountains is strongly influenced by a combination of health service gaps, infectious diseases, socio-cultural factors, and insufficient maternal knowledge. Strengthening maternal Education, improving sanitation, addressing harmful cultural practices, and expanding access to health services are critical strategies to reduce stunting prevalence in highland and resource-limited areas of Indonesia

Background The link between obstructive sleep apnea (OSA) and serum testosterone levels is still unclear. Method This cross-sectional study analyzed data from the 2015–2016 NHANES cycle and an independent polysomnography (PSG) cohort (validation cohort). We examined associations between OSA severity and risks of testosterone deficiency. Additionally, we quantified the capacity of BOADAI and apnea-hypopnea index to assess testosterone deficiency in OSA patients. Results The study included 2,359 participants from the NHANES cohort and 172 from the standardized PSG cohort. A negative correlation was identified between OSA and serum testosterone levels. After multivariable adjustment, OSA patients exhibited a 31% increased risk of testosterone deficiency (odds ratio [OR] = 1.31, 95% confidence interval [CI]: (1.02, 1.70), p = 0.03). This risk escalated to 67% in severe OSA (OR = 1.67, 95% CI: (1.04–2.68), p = 0.03) versus controls. The BOADAI showed stronger inverse correlation with testosterone(r = −0.37) and remained independently associated with testosterone deficiency (OR = 2.37, 95% CI:(1.12–5.32), p = 0.01). Conclusions This study provided evidence of a negative association between OSA and serum testosterone levels. The BOADAI, measurable at home via a finger-clip oximeter, provides an effective and more convenient monitoring alternative for monitoring testosterone levels in OSA management.

In March 2020, Australia experienced its first large COVID-19 outbreak in a healthcare setting when two persons who had returned from cruise ship travel were admitted to a hospital in North West Tasmania, leading to sustained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among healthcare workers (HCWs) in this hospital and another hospital co-located in the same health precinct. We examined factors influencing SARS-CoV-2 transmission in these hospitals to inform policies and practices that could reduce the risk of future outbreaks. Using the results of a survey and SARS-CoV-2 testing of HCWs who attended work at one or both hospitals during the exposure period (20 March to 13 April 2020), we assessed the association of demographic variables, work-related variables, and the average score for each of three infection prevention and control (IPC) measures (hand hygiene, personal protective equipment [PPE] donning and doffing, and personal distancing) with being a COVID-19 case using logistic regression. Of the 1779 HCWs invited to participate in the survey, 410 responded, of which 125 met the inclusion criteria for our analysis. On multivariable regression analysis, HCWs who were aged 31-50 years (odds ratio [OR] = 0.12 [95% confidence interval (CI): 0.03, 0.48]) or 51+ years (OR = 0.17 [95% CI: 0.04, 0.68]) had significantly lower odds of being a COVID-19 case when compared with HCWs who were aged 30 years or less, whereas those who worked part time (OR = 0.29 [95% CI: 0.08, 0.91]) had significantly lower odds of being a COVID-19 case when compared with HCWs who worked full time. HCWs having direct care of a COVID-19-positive patient (OR=5.42 [95% CI: 1.65, 20.8]) had significantly higher odds of being a COVID-19 case when compared with HCWs without direct care of a COVID-19-positive patient. The IPC measures showed no significant association with COVID-19 case status. Our study identified important associations between COVID-19 acquisition and age, work frequency, and direct contact with COVID-19 patients. However, the small sample size of IPC measures meant our study was inadequately powered to determine the significance of these associations with COVID-19 acquisition.

Although opioids primarily act on the central nervous system, they also affect the cardiovascular (CV) system. This study aimed to examine the association between long-term opioid use and the risk of CV events in individuals with noncancer pain. We conducted a nationwide observational cohort study using data from the Korean National Health Insurance Service, linked to the national health check-up database, between 2009 and 2018. Patients prescribed opioids for ≥90 days were defined as chronic users. After 1:10 propensity score matching, Cox proportional hazards models were used to estimate the risk of myocardial infarction (MI) and ischaemic stroke (IS), reported as hazard ratios (HRs) with 95% confidence intervals (CIs), compared to nonopioid users. The final analysis included 36 300 opioid users and 334 590 matched controls. Chronic opioid use was significantly associated with increased risk of MI (HR 1.20, 95% CI: 1.12-1.30; P = 0.001) and IS (HR 1.16, 95% CI: 1.12-1.21; P < 0.001). Subgroup analyses indicated that the association between opioid use and CV events varied by factors such as prior major CV diseases, anticoagulant use, area of residence, and gabapentinoid use. Long-term opioid use in patients with noncancer pain is associated with an increased risk of CV events. These findings underscore the need for careful CV risk assessment when initiating or maintaining chronic opioid treatment.

Chronic inflammation may be a key driving force in the development and progression of Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs). Statins, commonly used to lower cholesterol, also possess antiproliferative, proapoptotic, and anti-inflammatory properties that may be beneficial in the treatment of patients with MPN. This retrospective cohort study investigated whether statin use, in addition to standard cytoreductive therapy, shortens the time required to achieve hematological and molecular responses, while allowing for lower cytoreductive drug dosages. A total of 129 patients were included, with 53 receiving statins from diagnosis. The study found that statin users achieved complete hematological response (CHR) significantly faster than nonusers (median time: 8 vs 18 months; hazard ratio [HR], 2.1; 95% confidence interval [CI], 1.4-3.1; P = .0003). Among patients treated with pegylated interferon-alfa2 (IFN-α2), the CHR rate was 97% in statin users vs 83% in nonusers (HR, 2.5; 95% CI, 1.5-3.9; P = .0004), and a higher proportion of statin users sustained CHR throughout follow-up. Additionally, IFN-treated statin users received a significantly lower mean dose of IFN-α2. A dose-response relationship was observed, with higher statin intensity associated with an increase of CHR. Furthermore, statin use was significantly associated with achieving a partial molecular response among IFN-α2-treated patients (HR, 2.6; 95% CI, 1.1-6.0; P = .029). No significant association was observed in hydroxyurea (HU)-treated patients. These findings suggest that statins may enhance the efficacy of IFN-α2 in patients with MPN, while their benefit in HU-treated patients remains unclear. Prospective studies are warranted to further explore the therapeutic potential of statins in MPNs.

Relapsed/refractory (R/R) follicular lymphoma (FL) is a chronic disease often requiring multiple lines of therapy. Covalent Bruton tyrosine kinase inhibitor (BTKi) monotherapy has resulted in variable response rates, yet patients invariably experience relapse. While newer therapies such as bispecific antibodies and chimeric antigen receptor T-cell (CAR T cell) therapy are available, patient access and eligibility remain challenging. Here, we report the safety and efficacy of pirtobrutinib, a noncovalent (reversible) BTKi monotherapy in a R/R FL cohort from the multicenter phase 1/2 BRUIN study. Key end points included investigator-assessed overall response rate (ORR) per Lugano 2014 criteria, duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety. Among 48 patients with FL, the median age was 64.5 years (range, 37.0-85.0). Patients had received a median of 3 (range, 1-12) prior lines of therapy. The ORR with pirtobrutinib was 52.1% (95% confidence interval [CI], 37.2-66.7), and median DoR was 10.2 months (95% CI, 3.7-25.7). Median PFS was 5.8 months (95% CI, 3.8-8.1), and median OS was not estimable, with a median follow-up of 35.2 months (interquartile range, 31.1-41.8). The estimated DoR, PFS, and OS rates at 24 months were 33.3% (95% CI, 15.9-51.9), 25.6% (95% CI, 13.9-39.1), and 75.1% (95% CI, 59.5-85.4), respectively. Pirtobrutinib was well tolerated, with 2 patients (4.2%) discontinuing treatment due to adverse events (AEs; 1 treatment-related) and 4 patients (8.3%) having dose reductions due to AEs (all treatment related). Pirtobrutinib showed promising efficacy and was well tolerated in this cohort of patients with heavily pretreated R/R FL, warranting further investigation. This trial was registered at www.clinicaltrials.gov as #NCT03740529.

Reduced risk of hepatocellular carcinoma in the use of fibrate as an add-on to statin: A retrospective population-based cohort study.

Laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis, cholycystitis and other gall bladder diseases. The adoption of robotic-assisted surgery has increased, but its comparative clinical outcomes remain debated. This meta-analysis compares the clinical outcomes of robotic versus laparoscopic cholecystectomy. A comprehensive literature search was conducted in PubMed, Cochrane, Scopus and Embase from inception until August 2025 to identify relevant studies. Risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes with 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed using I2 and X2 statistics. Statistical analysis was performed using RevMan 5.4.1. A p value < 0.05 was considered statistically significant A total of 1,770,300 patients across twenty five included studies were analyzed. Pooled results showed no significant differences between robotic and laparoscopic cholecystectomy in terms of surgical success rate (OR = 1.71, 95% CI: [0.85-3.44]), overall complications (OR = 0.96, 95% CI: [0.89-1.04]), postoperative complications (OR = 0.99, 95% CI: [0.94-1.04]), 30-day readmission (OR = 1.00, 95% CI: [0.93-1.08]), length of hospital stay (MD=-0.02 days, 95% CI: [-0.29 to 0.25]), and major bile duct injury (OR = 1.42,95% CI[0.43-4.66]). Robotic cholecystectomy was associated with a significantly lower conversion to open surgery (OR = 0.35,95% CI: [0.31-0.41], p < 0.00001) but required longer operative time (MD = 12.65min, 95% CI: [6.95-18.35], p < 0.0001). Robotic cholecystectomy is a safe and effective alternative to the laparoscopic approach, demonstrating equivalent success and complication profiles with a distinct advantage in reducing conversions to open surgery. The high heterogeneity for some outcomes suggests careful patient selection is warranted.

Background Gene polymorphisms of ESRα Pvull (rs2234693), Xbal (rs9340799), and ESRβ Alul (rs4986938) and RsaI (rs1256049), have been investigated for their associations with prostate cancer risk. However, the nature of these relationships remains ambiguous. Therefore, the present study aimed to further clarify the association between ESR gene polymorphisms and prostate cancer. Objective To investigate the association between ESRα Pvull (rs2234693), Xbal (rs9340799), and ESRβ Alul (rs4986938), Rsal (rs1256049) polymorphisms and prostate cancer risk. Materials and methods PubMed, Medline, and CNKI were searched. Associations were assessed using odds ratios (ORs) with 95% confidence intervals (CIs). The false-positive report probability (FPRP), Bayesian false discovery probability (BFDP), and Venetian criteria were used to evaluate the credibility of statistically significant findings. Results We found for the first time that, overall, the ESRα PvuII polymorphism was significantly associated with a reduced risk of prostate cancer (pp vs. Pp + PP: OR = 0.83, 95% CI = 0.71–0.97; pp vs. PP: OR = 0.75, 95% CI = 0.57–0.99; p vs. P: OR = 0.88, 95% CI = 0.78–0.99). A similarly reduced risk was observed in Caucasians (pp + Pp vs. PP: OR = 0.01, 95% CI = 0.01–0.04). By contrast, the ESRα PvuII polymorphism increased prostate cancer risk among Africans (pp + Pp vs. PP: OR = 2.38, 95% CI = 1.61–3.51). For ESRβ RsaI , we observed a reduced risk of prostate cancer in Asians (r vs. R: OR = 0.87, 95% CI = 0.77–0.98). However, no significant associations were identified for ESRα XbaI or ESRβ AluI . When evaluating credibility using the FPRP, BFDP, and Venetian criteria, no statistically robust associations were confirmed. Conclusions Overall, the results suggest a potential association between the ESRα PvuII and ESRβ RsaI polymorphisms and prostate cancer risk, although the credibility assessments did not support statistically robust relationships.