Prostate calculi in cancer and BPH in a cohort of Korean men: Presence of calculi did not correlate with cancer risk.
ABSTRACT Prostatic calculi are common and are associated with inflammation of the prostate. Recently, it has been suggested that this inflammation may be associated with prostate carcinogenesis. The aim of this study was to investigate the relationship between prostatic calculi and prostate cancer (PCa) in prostate biopsy specimens. We retrospectively analyzed 417 consecutive patients who underwent transrectal ultrasonography (TRUS) and prostate biopsies between January 2005 and January 2008. Based on the biopsy findings, patients were divided into benign prostatic hyperplasia and PCa groups. TRUS was used to detect prostatic calculi and to measure prostate volume. The correlations between PCa risk and age, serum total PSA levels, prostate volume, and prostatic calculi were analyzed. Patient age and PSA, as well as the frequency of prostatic calculi in the biopsy specimens, differed significantly between both the groups (P < 0.05). In the PCa group, the Gleason scores (GSs) were higher in patients with prostatic calculi than in patients without prostatic calculi (P = 0.023). Using multivariate logistic regression analysis, we found that patient age, serum total PSA and prostate volume were risk factors for PCa (P = 0.001), but that the presence of prostatic calculi was not associated with an increased risk of PCa (P = 0.13). In conclusion, although the presence of prostatic calculi was not shown to be a risk factor for PCa, prostatic calculi were more common in patients with PCa and were associated with a higher GS among these men.
- [show abstract] [hide abstract]
ABSTRACT: Information on suspected risk factors for prostate cancer was obtained from in-person interviews as part of a case-control study of tissue sex hormone receptors and serum hormone levels. The risk factors examined were medical history (including venereal disease), sexual history, smoking, alcohol consumption, and occupational exposures. Study subjects were 40 prostate cancer patients and 64 benign prostatic hyperplasia controls who were newly diagnosed during 1984-1985 at North Carolina Memorial Hospital in Chapel Hill. Subjects were white and black men aged 50 years and older. Comparisons of cases' and controls' past medical histories did not support a venereal disease hypothesis of prostate cancer etiology. The most prominent finding is an association with farming employment: 75% of cases compared to 38% of controls reported farmwork occupations. Exposures to pesticides and herbicides, while more common among the patients, did not account for the association detected for farming. No relationship was observed with cadmium exposure, the most frequently cited occupational risk factor for prostate cancer.The Prostate 02/1987; 10(1):79-88. · 3.84 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Context Sexual activity has been hypothesized to play a role in the development of prostate cancer, but epidemiological data are virtually limited to case-control studies, which may be prone to bias because recall among individuals with prostate cancer could be distorted as a consequence of prostate malignancy or ongoing therapy.Objective To examine the association between ejaculation frequency, which includes sexual intercourse, nocturnal emission, and masturbation and risk of prostate cancer.Design, Setting, and Participants Prospective study using follow-up data from the Health Professionals Follow-up Study (February 1, 1992, through January 31, 2000) of 29 342 US men aged 46 to 81 years, who provided information on history of ejaculation frequency on a self-administered questionnaire in 1992 and responded to follow-up questionnaires every 2 years to 2000. Ejaculation frequency was assessed by asking participants to report the average number of ejaculations they had per month during the ages of 20 to 29 years, 40 to 49 years, and during the past year (1991).Main Outcome Measure Incidence of total prostate cancer.Results During 222 426 person-years of follow-up, there were 1449 new cases of total prostate cancer, 953 organ-confined cases, and 147 advanced cases of prostate cancer. Most categories of ejaculation frequency were unrelated to risk of prostate cancer. However, high ejaculation frequency was related to decreased risk of total prostate cancer. The multivariate relative risks for men reporting 21 or more ejaculations per month compared with men reporting 4 to 7 ejaculations per month at ages 20 to 29 years were 0.89 (95% confidence interval [CI], 0.73-1.10); ages 40 to 49 years, 0.68 (95% CI, 0.53-0.86); previous year, 0.49 (95% CI, 0.27-0.88); and averaged across a lifetime, 0.67 (95% CI, 0.51-0.89). Similar associations were observed for organ-confined prostate cancer. Ejaculation frequency was not statistically significantly associated with risk of advanced prostate cancer.Conclusions Our results suggest that ejaculation frequency is not related to increased risk of prostate cancer. Sexual activity is hypothesized to affect prostate carcinogenesis through numerous etiologic pathways. One of the most commonly postulated mechanisms implicates increased sexual activity as an indicator of higher androgenic activity and thus a marker for a high-risk population.1 Another mechanism proposes that sexual activity represents a marker for opportunity for exposure to infectious agents, although no sexually transmitted infection has been consistently implicated in prostate cancer development.2 An alternative hypothesis suggests that a reduced ejaculatory output in otherwise normal men is an etiologic risk factor for prostate cancer. That proposition is based on the theory that infrequent ejaculation increases the risk of prostate cancer because of retained carcinogenic secretions in the prostatic acini.3 A further hypothesis implicates repression of sexuality as a risk factor for prostate cancer and is derived from reports of greater sexual drive coupled with deprived sexual activity4 and greater interest in more sexual intercourse than experienced5 among prostate cancer cases compared with controls. In the United States, 38% of married persons aged 60 years or older reportedly engage in sexual activity between 1 and 4 times per month, and 14% indicate being sexually active at least 5 times per month.6 Although the libido declines with age, sexual activity is common among 70-, 80-, and even 90-year-old men.7 Given that sexual activity is common, including in older men,6- 7 and that prostate cancer risk is high,8 any association between these factors would have clinical and public health relevance. A recent meta-analysis9 reported an increased risk of prostate cancer with greater sexual activity (odds ratio, 1.2; 95% confidence interval [CI], 1.1-1.3 for an increase in sexual activity of 3 times per week). Epidemiological data on sexual activity and prostate cancer are almost entirely limited to case-control studies,2,9- 10 which may be particularly prone to methodological bias because information on prediagnosis sexual activity is collected after the diagnosis of cancer. Sexual function may diminish after the diagnosis of prostate cancer and its treatment,11 and recall of past levels of sexual activity among individuals with prostate cancer could be distorted as a consequence of prostate malignancy or ongoing therapy. Prospective data on self-reported sexual activity and prostate cancer are restricted to 2 investigations. These studies12- 13 considered age at first marriage, marital status, and number of children as measures of sexual activity and found no association between these factors and prostate cancer. Thus, the relationship between sexual activity and risk of prostate cancer is not clear. To help resolve this issue, we prospectively examined the association between ejaculation frequency and risk of prostate cancer in the Health Professionals Follow-up Study, a large cohort of middle-aged US men. We focused on ejaculation frequency, capturing sexual intercourse, nocturnal emission, and masturbation. Thus, our exposure definition encompasses a wide range of variability in exposure to sexual activity. In addition, we reasoned that by examining ejaculation frequency, the effects of sexual function per se would be more readily distinguishable from effects related to exposure to sexually transmitted agents, which we do not consider in this article.JAMA The Journal of the American Medical Association 291(13):1578-1586. · 29.98 Impact Factor
- BJU International 06/2007; 99(5):966-8. · 3.05 Impact Factor