Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Fatma Shebl


Prostate cancer is the most common type of non-skin malignancy diagnosed among men, but the disease etiology and risk factors remain inconclusive. Hepatitis C virus (HCV) infection's prevalence is increasing in the US population. Studies have shown that the concentration of free serum testosterone, which may be directly associated with prostate cancer risk, was decreased among men with HCV infection. In order to evaluate the relationship between HCV infection and prostate cancer risk, we conducted a population-based case-control study using the SEER-Medicare dataset.

The study included 194,339 prostate cancer cases and 54,481 controls which were frequency-matched to the cases by age, race, and calendar period of selection. After adjusting for matching factors and potential confounders, including geographic region of SEER registry/area, HBV infection, HIV infection, hypertension, number of hospitalization, number of outpatient visits, number of physician visits, and PSA test 0-0.99 years prior to index date, history of HCV infection was significantly associated with decreased risk of prostate cancer (OR 0.76, 95% CI: 0.63-0.93). In addition, with the controls as the reference group, we observed HCV infection to be associated with reduced prostate cancer risk within each prostate cancer stage category at diagnosis: localized (OR 0.86, 95% CI: 0.59-1.24), regional (OR 0.90, 95% CI: 0.43-1.89), distant (OR 0.56, 95% CI: 0.26-1.17), and unstaged (OR 0.62, 95% CI: 0.38-1.00).

Our finding that HCV infection is associated with reduced prostate cancer risk may lead to a greater understanding of prostate cancer etiology. Future research will be needed to elucidate the underlying biological mechanism for this inverse association.


This is an Open Access Thesis.

Open Access

This Article is Open Access