Is there a link between gonorrhea and prostate cancer?

Prostate Cancer, SEM
Prostate Cancer, SEM. STEVE GSCHMEISSNER / Science Photo Library / Getty Images

Usually when STD researchers are talking about a link between cancer and an STD, they're talking about HPV. The human papillomavirus has been linked to increased risk of cervical cancer, penile cancer, anal cancer, and many more. However, HPV isn't the only STD that's linked to increased cancer risk. In a 2015 meta-analysis of 21 studies, scientists found an association between gonorrhea and prostate cancer.

The association was particularly strong in studies of African American men.

There is, however, an important difference between the data on HPV and cancer and the data on gonorrhea. Years of studies have clearly shown that there is a causal relationship between HPV and cancer. Although not all HPV infections with high-risk virus will become cancer, it is changes associated with viral infections that cause cancer. In contrast, all the gonorrhea research shows is that men with gonorrhea, particularly African-American men, are more likely to develop prostate cancer down the road.

This association does not mean that gonorrhea infection causes prostate cancer. Instead, it's possible that gonorrhea is a marker for another prostate cancer risk factor, such as sexual activity. In fact, a 2014 meta-analysis also found an association between prostate cancer and STDs more generally. That might support such an indirect hypothesis, as well as the possibility of more direct causation.

That's not to say that gonorrhea couldn't directly lead to prostate cancer. Scientists have proposed that inflammation caused by the bacterial infection could damage prostate cells, but that's only a theory. It has not yet been demonstrated. What research has shown is that both chlamydia and gonorrhea infection can affect the prostate.

Scientists who have monitored prostate specific antigen during these infections have seen increases in some, but not all, men.

What does it all mean? It's not yet clear. Although gonorrhea is clearly associated with prostate cancer in some populations, we don't yet know why. It may be a causal factor, but it may confound another association. In addition, it's important to note that prostate cancer isn't associated with gonorrhea in every population. There's still a lot left to learn.


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