Circumcision and Prostate Cancer Mortality in the Cancer Prevention Study-I Public

Abstract

PROBLEM

Previous research has examined the role of sexually transmitted infections (STIs) on prostate cancer etiology. A meta-analysis of 34 case-control, 10 nested case-control, and 3 cohort design studies found that men with a history of any STIs had a 50% higher risk of prostate cancer. Circumcision has also been found to be associated with a lowered risk for some STIs, with the notable exception of gonorrhea. However, based on the literature, previous studies examining the association between circumcision and prostate cancer have been limited to 7 case-control and 1 cross-sectional studies. Thus far, no studies have attempted to examine the association with prostate cancer mortality as the main outcome and studied the association in a cohort study.

METHODS

The association between self-reported circumcision status and prostate cancer mortality was examined using data from 449,320 men in the Cancer Prevention Study I (CPS-I) cohort. Information on date and cause of death was collected by volunteers and verified using death certificates. Cox proportional hazards modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

During a median follow-up time of 12.8 years, 1,990 men died of prostate cancer. No statistically-significant association was found between circumcision and prostate cancer mortality (HR=0.96, 95% CI 0.85-1.08).

CONCLUSIONS

This study found no association between circumcision and prostate cancer mortality compared to seven out of eight case-control studies that found an inverse association between circumcision and prostate cancer incidence. Further studies should be conducted using more recent data.

Table of Contents

DISTRIBUTION AGREEMENT ………........................................................................................……………………………..……………….. i

APPROVAL SHEET …………………….......................................................................................………………………………...…………..… ii

ABSTRACT COVER PAGE …………........................................................................................…………………………………..………….… iii

ABSTRACT ………………..........................................................................................………………………………………………………….… iv

COVER PAGE ……………..........................................................................................………………………………………………….……….… v

ACKNOWLEDGEMENTS …………........................................................................................…………………………………….………….… vi

TABLE OF CONTENTS ………………........................................................................................…………………………..……….……….… vii

LIST OF TABLES …………………….........................................................................................……………………………………...……..… viii

CHAPTER

1              BACKGROUND AND LITERATURE REVIEW …………....................................................................................………………...… 1

Background …………………………………………………….........................................................................….........................……………… 1

Significance ……………………………………………………..................................................................................................………………… 2

2              MANUSCRIPT ………………………………………………......................................................................................………………..… 6

Abstract ……………………………………………………………………...................................................................................................…..… 6

Introduction ………………………………………………………………..................................................................................................……… 7

Methods ………………………………………………………………...................................................................................................………..… 8

Study Population …………………………………………………...........................................................................................................……… 8

           Exposure …………………………………………….....................................................................................................…………………… 8

           Outcome ……………………………………………....................................................................................................………………….… 9

           Statistical Analysis ………………………………..................................................................................................…………………….… 9

Results ……………………………………………….....................................................................................................………………………..… 10

Discussion ………………………………………………………….....................................................................................................…………… 15

References …………………………………………………………….....................................................................................................………… 19

Supplemental Tables ………………………………………………...................................................................................................……..…… 22

3              SUMMARY, PUBLIC HEALTH IMPLICATIONS, POSSIBLE FUTURE DIRECTIONS ………………….......................………………....… 24

Summary ………………………………………………………………......................................................................................................…….… 24

Public Health Implications …………………...............……..............................................................................................………………..… 24

Future Considerations ………………………….……………...................................................................................................……………...… 25

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Oncology Health Sciences, Epidemiology
Mot-clé	Circumcision, Male Prostate Cancer Mortality Mortality Cohort Study Prostate Cancer
Committee Chair / Thesis Advisor	Dr. Michael Goodman, Emory University
Committee Members	Dr. Mia Gaudet, Emory University

Dernière modification

Primary PDF

Thumbnail	Title	Date Uploaded	Actions
	Circumcision and Prostate Cancer Mortality in the Cancer Prevention Study-I ()	2020-04-29 11:45:22 -0400	Press to Select an action Download

Supplemental Files

Thumbnail	Title	Date Uploaded	Actions