Sexually Transmitted Infections in Prostate Cancer: A Prospective Multicenter Analysis.

[INTRODUCTION] Chronic inflammation and infections have been implicated in prostate cancer (PCa) pathogenesis. The association between sexually transmitted infections (STIs) and PCa remains inconclusive. The objective was to evaluate the presence of STI-related pathogens in patients with PCa compared to a control group.

[METHODS] A prospective multicenter study involving 239 male patients with a clinical suspicion of PCa was conducted. Among the participants, 176 had histologically confirmed PCa, while 63 served as controls with benign histology. Urine, glans swabs, and prostate biopsy specimens were collected from each participant and analyzed using polymerase chain reaction (PCR) to detect a broad panel of STI-causing pathogens, including Candida spp., Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus types 1 and 2, and human papillomavirus.

[RESULTS] A total of 717 samples were processed. The detection frequency of STI-related pathogens was relatively low across all sample types. M. genitalium was the most frequently detected pathogen, particularly in prostate biopsy samples. No statistically significant association was found between the presence of these pathogens and the incidence of PCa. N. gonorrhoeae and C. spp. were not detected in any of the samples.

[CONCLUSION] This study did not find a statistically significant association between the presence of STIs and PCa. The low prevalence of STI pathogens despite the use of highly sensitive PCR methods suggests that these infections may play a limited role in prostate carcinogenesis. Future research should consider focusing on the role of the urinary and prostatic microbiome in chronic prostatic inflammation.