Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Cancer Causes Control. 2009 Nov;20(9):1623-34. doi: 10.1007/s10552-009-9409-9. Epub 2009 Aug 5.
Several epidemiologic studies have investigated sexually transmitted infections (STIs) and later risk of genitourinary conditions with suggestive positive results. While these results may reflect causal associations, other possible explanations include confounding by factors possibly related to both STI acquisition and genitourinary condition risk such as recognized STI-risk factors/correlates, and other factors not typically considered in relation to STIs (e.g., general health-related behaviors or markers of such behaviors). Very few of these factors have been investigated in older populations in which STIs and genitourinary conditions are typically studied. Therefore, we investigated STI history correlates in one such population, the Health Professionals Follow-up Study.
We ascertained histories of potential correlates, gonorrhea, syphilis by questionnaire (n = 36,032), and performed serologic testing for Chlamydia trachomatis, Trichomonas vaginalis, human papillomavirus, and human herpesvirus type 8 infection in a subset (n = 651).
Positive correlations were observed for African-American race, foreign birth, southern residence, smoking, alcohol consumption, ejaculation frequency, vasectomy, and high cholesterol. Inverse correlations were observed for social integration and routine health-related examinations.
These findings provide useful information on potential confounders for epidemiologic investigations of STIs and chronic diseases, and interesting new hypotheses for STI prevention (e.g., STI counseling before vasectomy).
几项流行病学研究调查了性传播感染(STI)与随后发生的泌尿生殖系统疾病之间的关系,结果显示两者存在正相关。虽然这些结果可能反映了因果关系,但其他可能的解释包括混杂因素的影响,这些混杂因素可能与 STI 的发生和泌尿生殖系统疾病的风险都有关,例如公认的 STI 风险因素/相关因素,以及其他通常与 STI 无关的因素(例如,与健康相关的一般行为或此类行为的标志物)。在 STI 和泌尿生殖系统疾病通常研究的老年人群中,很少有研究调查这些因素。因此,我们在一个这样的人群中,即健康专业人员随访研究中,调查了 STI 病史的相关因素。
我们通过问卷确定了潜在相关因素、淋病和梅毒的病史(n=36032),并对一小部分人(n=651)进行了沙眼衣原体、阴道毛滴虫、人乳头瘤病毒和人类疱疹病毒 8 感染的血清学检测。
观察到与非裔美国人种族、外国出生、南部居住、吸烟、饮酒、射精频率、输精管切除术和高胆固醇相关的正相关。与社会融合和常规健康相关检查呈负相关。
这些发现为 STI 和慢性疾病的流行病学研究提供了有用的混杂因素信息,并为 STI 预防提供了有趣的新假设(例如,在输精管切除术前进行 STI 咨询)。