PD21-01 SEXUALLY TRANSMITTED INFECTIONS, BENIGN-PROSTATIC HYPERPLASIA AND NOCTURIA: RESULTS FROM THE PROSTATE, LUNG, COLORECTAL, AND OVARIAN CANCER SCREENING TRIAL

INTRODUCTION AND OBJECTIVES: The exact pathogenesis of benign prostatic hyperplasia (BPH) and related lower urinary tract symptoms (LUTS) remain unclear; however evidence supports a role of inflammation. One possible source of prostatic inflammation is sexually transmitted infections (STIs), which have been found to be positively related to subsequent LUTS in several small case-control studies. The objective of our analysis is to examine whether a history of STIs or positive STI serology is associated with prevalent and incident BPHrelated outcomes in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). METHODS: Self-reported history of STIs (gonorrhea, syphilis) was ascertained at baseline, and serological STIs (Chlamydia trachomatis, Trichomonas vaginalis, HPV-16, HPV-18, HSV-2, CMV and HHV-8) were detected using baseline serum specimens. We used data collected on the baseline questionnaire, as well as results from the baseline PSA test and digital rectal exam (DRE), to define prevalent BPH-related outcomes as evidence of LUTS (self-reported diagnosis of an enlarged prostate/BPH, BPH surgery, or nocturia (waking iÝ2times/night to urinate)) and evidence of prostate enlargement (PSA>1.4 ng/mL or prostate volume iÝ30 mL) in men without prostate cancer. We created a similar definition of incident BPH using data from the follow-up questionnaire completed 5-13 years after enrollment ((self-reported diagnosis of an enlarged prostate/BPH or nocturia), data on finasteride use during follow-up, and results from the follow-up PSA tests and DREs. We used Poisson regression with robust variance estimation to calculate prevalence ratios in our cross-sectional analysis of self-reported (n1⁄432,900) and serological STIs (n1⁄41,143) with prevalent BPH, and risk ratios in our prospective analysis of self-reported STIs with incident BPH (n1⁄45,226). RESULTS: Generally null results were observed for a self-reported history of STI or positive STI serologies with prevalent and incident BPH related outcomes, with the possible exception of T. vaginalis. CONCLUSIONS: Our findings do not support a causal role of STIs in the pathogenesis of BPH related outcomes, although T. vaginalis infection may warrant further study. Prevalent BPH-related outcomes Incident BPH-related outcomes