Men with a history of gonorrhoea have a two-fold increased risk of bladder cancer, according to a study published in the British Journal of Cancer* today (Tuesday).

The study – led by researchers at the Harvard School of Public Health in the USA – is the first prospective study to confirm the link.

Bladder cancer is the fourth most commonly diagnosed cancer in UK men. Gonorrhoea is the second most commonly diagnosed bacterial sexually transmitted infection (STI) in the UK.

The paper comes from the Health Professionals Follow-Up Study – which has monitored the health of 51,529 men in the USA since 1986 through detailed questionnaires and medical records. The researchers identified 286 cases of bladder cancer for which complete information on gonorrhoea history was available.

Dr Dominique Michaud, Assistant Professor of Epidemiology at the Harvard School of Public Health and lead author on the paper, said: “Two studies have previously suggested a link between gonorrhoea and bladder cancer in men. But these were retrospective studies – meaning information on gonorrhoea history was gathered after the cancer was diagnosed. These studies can sometimes give misleading results. Gonorrhoea is an infection that often recurs, causing local inflammation and symptoms such as incomplete emptying of the bladder. The inflammation itself or the associated symptoms could be contributing to the development of bladder cancer. The severity and frequency of these symptoms may dictate the extent of the increased risk.”

The researchers also found that a history of gonorrhoea increases the risk of invasive bladder cancer to a greater degree than superficial cancer. Patients with invasive cancer have a poorer prognosis.

Professor John Toy, medical director of Cancer Research UK, which owns the British Journal of Cancer, said: “This study strengthens the suspected link between infection with the gonorrhoea bacterium and bladder cancer in men. The next step is to confirm whether the increased risk could be caused directly by the gonorrhoea infection or its symptoms. Further research is also needed to exclude the possibility that gonorrhoea is acting as a marker for the real cancer-causing agent, such as a separate infection. A number of the biological processes that cause body tissues to become inflamed are also involved in the development of cancer, and scientists around the world are looking at how the inflammation might be causally linked to cancer in certain cases.”


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* Michaud, D. et al. (2007) British Journal of Cancer, Volume 96 Issue 1 – click here for more information.

Bladder cancer

Further information on bladder cancer and its treatment is available at CancerHelp and Cancer Research UK.

Around 10,150 people are diagnosed with bladder cancer in the UK each year, and more than 4,800 people die of the disease.

Smoking cigarettes is the principal preventable risk factor for bladder cancer in both men and women.

The highest incidence rates for bladder cancer are generally found in industrially developed countries, particularly in North America and Western Europe, and in areas associated with endemic schistosomiasis in Africa and the Middle East. In the UK bladder cancer is the fourth most common cancer in males, with 7,201 new cases diagnosed in 2003. This compares to 2,947 female cases, giving a male:female ratio of 5:2.

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