TRICHOMONOSIS AND PROSTATE CANCER RISK IN THE PLCO CANCER SCREENING TRIAL

PLCO 癌症筛查试验中的滴虫病和前列腺癌风险

• 批准号: 8049516
• 负责人: Siobhan Sutcliffe
• 金额: $ 8.82万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-21 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8049516
• 关键词: Aliquot; Antibiotic Therapy; Antibiotics; Chlamydia trachomatis; Clinical; Collection; Colorectal Cancer; Cytomegalovirus; Development; Disease; Epidemiologic Studies; Etiology; Gonorrhea; Health education; Herpesviridae; Human Papillomavirus; Individual; Infection; Inflammation; Investigation; Lead; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measures; Nested Case-Control Study; Participant; Population Study; Prevention; Prevention strategy; Primary Prevention; Prostate; Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; Protocols documentation; Protozoan Infections; Public Health; Recording of previous events; Risk; Sample Size; Screening for Ovarian Cancer; Screening for Prostate Cancer; Screening for cancer; Screening procedure; Serum; Sex Behavior; Sexual Health; Sexually Transmitted Diseases; Simplexvirus; Specimen; Staging; Syphilis; Time; Trichomonas Infections; Trichomonas vaginalis; Vaccines; base; cancer diagnosis; cancer risk; cost; design; high risk; high risk sexual behavior; innovation; low socioeconomic status; men; men' s group; novel; prevent; prospective; prostate carcinogenesis; vaccine development

DESCRIPTION (provided by applicant): ABSTRACT Although inflammation is increasingly believed to be involved in prostate carcinogenesis, responsible cause(s) of inflammation are still unclear. One promising, possible responsible cause is Trichomonas vaginalis infection (trichomonosis), a common, sexually transmitted protozoan infection with known prostate involvement. We previously investigated trichomonosis and prostate cancer risk in three epidemiologic studies of predominantly White men, two of which observed a positive association between T. vaginalis serostatus and prostate cancer, particularly high-grade or late-stage disease, while the third observed no association with very early-stage disease. Collectively, these findings suggest that trichomonosis may be associated with risk of aggressive prostate cancer, at least in White men. To our knowledge, no studies have investigated associations between trichomonosis and prostate cancer risk among Black men, despite their higher risks of both trichomonosis and prostate cancer. Therefore, to extend our promising findings for trichomonosis and prostate cancer risk to Black men (Aim 1), and to investigate the relation between trichomonosis and aggressive prostate cancer risk (Aim 2), we propose to conduct an epidemiologic investigation of trichomonosis and prostate cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). The proposed study will be the largest investigation of trichomonosis and prostate cancer risk to date, and will build upon promising findings from a previous nested case-control study of sexually transmitted infections (STIs) and prostate cancer risk in PLCO, in which the authors observed no associations between individual STIs and risk of prostate cancer, but a modest positive association between a history of any STIs combined and prostate cancer, suggesting that another unmeasured STI, such as trichomonosis, might be associated with risk of prostate cancer in this study population. The proposed study is timely and innovative because it extends our recently observed promising findings for trichomonosis and prostate cancer risk among predominantly White men to Black men, and it is significant because our findings could lead to the development of novel primary prevention strategies for prostate cancer, particularly prostate cancer with the greatest potential for progression to fatal disease. Primary prevention strategies based on our findings would be simple and inexpensive to implement because trichomonosis can be easily prevented by safe sexual behavior, and easily screened and treated with currently available, inexpensive antibiotics. A vaccine could also conceivably be developed for this common infection. Therefore, given the potentially high public health and clinical impact of our findings, extension to important sub-groups of men (i.e., Black men), and confirmation of our suggestive findings for aggressive disease are clearly needed. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE The proposed study is relevant to public health because it investigates a promising, possible cause (Trichomonas vaginalis infection or trichomonosis) of prostate cancer, particularly prostate cancer that is most likely to be fatal. Very little is currently known about the cause(s) of prostate cancer, and few prevention strategies exist. Therefore, if we observe a positive association between a history of trichomonosis and prostate cancer risk in our study, this finding could lead to a better understanding of prostate cancer development, and novel prevention strategies for prostate cancer, such as prevention of trichomonosis through reduced risky sexual behaviors or vaccine development, and screening and treatment of existing infections by antibiotics.

描述（由申请人提供）：摘要尽管越来越多的人认为炎症与前列腺癌的发生有关，但炎症的原因仍不清楚。一个有希望的，可能负责的原因是阴道毛滴虫感染（滴虫病），一种常见的，性传播的原生动物感染与已知的前列腺受累。我们以前在三项以白色男性为主的流行病学研究中调查了滴虫病和前列腺癌的风险，其中两项研究观察到滴虫病和前列腺癌之间的正相关。第三组与前列腺癌，特别是高级别或晚期疾病有关，而第三组与非常早期的疾病无关。总的来说，这些发现表明，至少在白色男性中，滴虫病可能与侵袭性前列腺癌的风险有关。据我们所知，没有研究调查黑人男性中滴虫病和前列腺癌风险之间的关联，尽管他们患滴虫病和前列腺癌的风险更高。因此，为了将我们对滴虫病和前列腺癌风险的有希望的发现扩展到黑人男性（目标1），并调查滴虫病和侵袭性前列腺癌风险之间的关系（目标2），我们建议在前列腺、肺、结直肠和卵巢癌筛查试验（PLCO）中进行滴虫病和前列腺癌风险的流行病学调查。这项拟议的研究将是迄今为止最大规模的关于毛癣菌病和前列腺癌风险的研究，并将建立在之前PLCO中性传播感染（STI）和前列腺癌风险的巢式病例对照研究的有希望的发现的基础上，其中作者观察到个体性传播感染（STI）与前列腺癌风险之间没有相关性，但任何STI合并病史与前列腺癌之间存在适度的正相关性，提示另一种未测量的STI，如滴虫病，可能与本研究人群中前列腺癌的风险相关。这项拟议的研究是及时和创新的，因为它扩展了我们最近观察到的有希望的发现，主要是白色男性中的滴虫病和前列腺癌的风险，这是重要的，因为我们的研究结果可能导致前列腺癌，特别是前列腺癌的发展，最有可能发展成致命的疾病的新的一级预防策略的发展。基于我们的研究结果的初级预防策略将是简单和廉价的实施，因为滴虫病可以很容易地通过安全的性行为来预防，并且很容易用目前可用的廉价抗生素进行筛查和治疗。可以想象，也可以为这种常见的感染开发疫苗。因此，考虑到我们的研究结果潜在的高公共卫生和临床影响，扩展到重要的男性亚组（即，黑人），并确认我们的提示性发现的侵略性疾病显然是必要的。 公共卫生关系：该研究与公共卫生相关，因为它调查了前列腺癌的一个有希望的可能原因（阴道毛滴虫感染或滴虫病），特别是最有可能致命的前列腺癌。目前对前列腺癌的病因知之甚少，几乎没有预防策略。因此，如果我们在我们的研究中观察到滴虫病史与前列腺癌风险之间的正相关性，这一发现可能会导致更好地了解前列腺癌的发展，以及前列腺癌的新预防策略，例如通过减少危险的性行为或疫苗开发来预防滴虫病，以及通过抗生素筛选和治疗现有感染。