Circumcision and Prostate Cancer Mortality in the Cancer Prevention Study-I Público
Roberts, Amelia (Spring 2020)
Published
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
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