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Feng X, Zhang Y, Vaselkiv JB, Li R, Nguyen PL, Penney KL, Giovannucci EL, Mucci LA, Stopsack KH. Modifiable risk factors for subsequent lethal prostate cancer among men with an initially negative prostate biopsy. Br J Cancer 2023; 129:1988-2002. [PMID: 37898724 PMCID: PMC10703766 DOI: 10.1038/s41416-023-02472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Previously suggested modifiable risk factors for prostate cancer could have resulted from detection bias because diagnosis requires a biopsy. We investigated modifiable risk factors for a subsequent cancer diagnosis among men with an initially negative prostate biopsy. METHODS In total, 10,396 participants of the Health Professionals Follow-up Study with an initial negative prostate biopsy after 1994 were followed for incident prostate cancer until 2017. Potential risk factors were based on previous studies in the general population. Outcomes included localised, advanced, and lethal prostate cancer. RESULTS With 1851 prostate cancer cases (168 lethal) diagnosed over 23 years of follow-up, the 20-year risk of any prostate cancer diagnosis was 18.5% (95% CI: 17.7-19.3). Higher BMI and lower alcohol intake tended to be associated with lower rates of localised disease. Coffee, lycopene intake and statin use tended to be associated with lower rates of lethal prostate cancer. Results for other risk factors were less precise but compatible with and of similar direction as for men in the overall cohort. CONCLUSIONS Risk factors for future prostate cancer among men with a negative biopsy were generally consistent with those for the general population, supporting their validity given reduced detection bias, and could be actionable, if confirmed.
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Affiliation(s)
- Xiaoshuang Feng
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Genomic Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Yiwen Zhang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - J Bailey Vaselkiv
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ruifeng Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paul L Nguyen
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Kathryn L Penney
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Konrad H Stopsack
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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2
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D’Ecclesiis O, Pastore E, Gandini S, Caini S, Marvaso G, Jereczek-Fossa BA, Corrao G, Raimondi S, Bellerba F, Ciceri S, Latella M, Cavalcabò NDB, Bendinelli B, Saieva C, Fontana M, Gnagnarella P. Association between Alcohol Intake and Prostate Cancer Mortality and Survival. Nutrients 2023; 15:nu15040925. [PMID: 36839283 PMCID: PMC9965886 DOI: 10.3390/nu15040925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
We conducted a systematic review and meta-analysis to investigate the role of alcohol consumption with the prognosis of prostate cancer (PCa). Published reports were gathered on 15 October 2022, from PUBMED/MEDLINE and EMBASE. We found 19 independent eligible studies on the association between consumption of alcoholic beverages and the risk of fatal PCa (n = 5), PCa mortality (n = 5) in healthy subjects, and PCa patients' survival (n = 7) or surrogates thereof (n = 2). We used random effects meta-analysis to obtain a summary risk estimate (SRE) and 95% confidence intervals (95%CI) for incidence of fatal PCa and PCa mortality. The meta-analysis revealed no association between alcohol consumption and fatal prostate cancer incidence risk in healthy subjects with an indication for publication bias, but omitting the study that mainly increased the between-study heterogeneity, the SRE becomes significant (SRE 1.33, 95%CI 1.12-1.58), and the heterogeneity disappeared (I2 = 0%) with no indication of publication bias. No association of alcohol consumption was found with mortality risk in PCa patients (SRE 0.97, 95%CI 0.92-1.03) and PCa mortality risk in healthy subjects (SRE 1.03, 95%CI 0.82-1.30). In conclusion, this study suggests that there is some evidence of an association between high alcohol consumption and an increased risk of incidence of fatal prostate cancer in healthy subjects. Given the inconsistencies this result warrants further confirmation.
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Affiliation(s)
- Oriana D’Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Elisa Pastore
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
- Correspondence:
| | - Saverio Caini
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Giulia Marvaso
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Barbara A. Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Giulia Corrao
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20139 Milan, Italy
| | - Silvia Ciceri
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Marialetizia Latella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Nora de Bonfioli Cavalcabò
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Benedetta Bendinelli
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Calogero Saieva
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Miriam Fontana
- Institute for Cancer Research, Prevention, and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, 20141 Milan, Italy
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3
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Lin HY, Tseng TS, Wang X, Fang Z, Zea AH, Wang L, Pow-Sang J, Tangen CM, Goodman PJ, Wolk A, Håkansson N, Kogevinas M, Llorca J, Brenner H, Schöttker B, Castelao JE, Gago-Dominguez M, Gamulin M, Lessel D, Claessens F, Joniau S, Park JY. Intake Patterns of Specific Alcoholic Beverages by Prostate Cancer Status. Cancers (Basel) 2022; 14:cancers14081981. [PMID: 35454886 PMCID: PMC9024489 DOI: 10.3390/cancers14081981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Previous studies have shown heavy intake of different alcoholic beverages affects prostate cancer (PCa) clinical outcomes differently. However, the intake patterns of specific alcoholic beverages for PCa status are understudied. The study’s objective is to evaluate intake patterns of total alcohol and three types of alcoholic beverage (beer, wine, and spirits) by PCa risk and aggressiveness status. This study included 10,029 men with European ancestry (4676 non-PCa men and 5353 PCa patients). We found PCa patients had a similar total heavy alcohol intake compared with non-PCa men. However, PCa patients were likely to drink more wine and spirits than non-PCa men. Patients with aggressive PCa drank more beer but not wine and spirits. Interestingly, heavy wine intake was inversely associated with PCa aggressiveness. These findings suggest that the intake patterns of specific alcoholic beverages differ by PCa status, and this information might help develop personalized alcohol intervention for PCa patients. Abstract Background: Previous studies have shown that different alcoholic beverage types impact prostate cancer (PCa) clinical outcomes differently. However, intake patterns of specific alcoholic beverages for PCa status are understudied. The study’s objective is to evaluate intake patterns of total alcohol and the three types of beverage (beer, wine, and spirits) by the PCa risk and aggressiveness status. Method: This is a cross-sectional study using 10,029 men (4676 non-PCa men and 5353 PCa patients) with European ancestry from the PCa consortium. Associations between PCa status and alcohol intake patterns (infrequent, light/moderate, and heavy) were tested using multinomial logistic regressions. Results: Intake frequency patterns of total alcohol were similar for non-PCa men and PCa patients after adjusting for demographic and other factors. However, PCa patients were more likely to drink wine (light/moderate, OR = 1.11, p = 0.018) and spirits (light/moderate, OR = 1.14, p = 0.003; and heavy, OR = 1.34, p = 0.04) than non-PCa men. Patients with aggressive PCa drank more beer than patients with non-aggressive PCa (heavy, OR = 1.48, p = 0.013). Interestingly, heavy wine intake was inversely associated with PCa aggressiveness (OR = 0.56, p = 0.009). Conclusions: The intake patterns of some alcoholic beverage types differed by PCa status. Our findings can provide valuable information for developing custom alcohol interventions for PCa patients.
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Affiliation(s)
- Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (X.W.); (Z.F.)
- Correspondence:
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
| | - Xinnan Wang
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (X.W.); (Z.F.)
| | - Zhide Fang
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (X.W.); (Z.F.)
| | - Arnold H. Zea
- Department of Microbiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Liang Wang
- Department of Tumor Biology, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
| | - Julio Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
| | - Catherine M. Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; (C.M.T.); (P.J.G.)
| | - Phyllis J. Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; (C.M.T.); (P.J.G.)
| | - Alicja Wolk
- Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden;
| | - Niclas Håkansson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| | - Manolis Kogevinas
- Barcelona Institute of Global Health (ISGlobal), 08036 Barcelona, Spain;
- IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain;
- University of Cantabria, 39005 Santander, Spain
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany; (H.B.); (B.S.)
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, D-69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), D-69120 Heidelberg, Germany; (H.B.); (B.S.)
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), 36204 Vigo, Spain;
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitariode Santiago, Servicio Galego de Saúde, SERGAS, 15706 Santiago de Compostela, Spain;
- Department of Family Medicine and Public Health, Moores Cancer Center, University of California San Diego, La Jolla, CA 92037, USA
| | - Marija Gamulin
- Department of Oncology, University Hospital Centre Zagreb, 10 000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia
| | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, D-20246 Hamburg, Germany;
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Campus Gasthuisberg, University of Leuven, Herestraat 49, P.O. Box 901, 3000 Leuven, Belgium;
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Herestraat 49, P.O. Box 7003 41, 3000 Leuven, Belgium;
| | - the PRACTICAL Consortium
- The Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome Consortium, Sutton SM2 5NG, UK;
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
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Macke AJ, Petrosyan A. Alcohol and Prostate Cancer: Time to Draw Conclusions. Biomolecules 2022; 12:375. [PMID: 35327568 PMCID: PMC8945566 DOI: 10.3390/biom12030375] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 01/25/2023] Open
Abstract
It has been a long-standing debate in the research and medical societies whether alcohol consumption is linked to the risk of prostate cancer (PCa). Many comprehensive studies from different geographical areas and nationalities have shown that moderate and heavy drinking is positively correlated with the development of PCa. Nevertheless, some observations could not confirm that such a correlation exists; some even suggest that wine consumption could prevent or slow prostate tumor growth. Here, we have rigorously analyzed the evidence both for and against the role of alcohol in PCa development. We found that many of the epidemiological studies did not consider other, potentially critical, factors, including diet (especially, low intake of fish, vegetables and linoleic acid, and excessive use of red meat), smoking, family history of PCa, low physical activity, history of high sexual activities especially with early age of first intercourse, and sexually transmitted infections. In addition, discrepancies between observations come from selectivity criteria for control groups, questionnaires about the type and dosage of alcohol, and misreported alcohol consumption. The lifetime history of alcohol consumption is critical given that a prostate tumor is typically slow-growing; however, many epidemiological observations that show no association monitored only current or relatively recent drinking status. Nevertheless, the overall conclusion is that high alcohol intake, especially binge drinking, is associated with increased risk for PCa, and this effect is not limited to any type of beverage. Alcohol consumption is also directly linked to PCa lethality as it may accelerate the growth of prostate tumors and significantly shorten the time for the progression to metastatic PCa. Thus, we recommend immediately quitting alcohol for patients diagnosed with PCa. We discuss the features of alcohol metabolism in the prostate tissue and the damaging effect of ethanol metabolites on intracellular organization and trafficking. In addition, we review the impact of alcohol consumption on prostate-specific antigen level and the risk for benign prostatic hyperplasia. Lastly, we highlight the known mechanisms of alcohol interference in prostate carcinogenesis and the possible side effects of alcohol during androgen deprivation therapy.
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Affiliation(s)
- Amanda J. Macke
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Armen Petrosyan
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA;
- The Fred and Pamela Buffett Cancer Center, Omaha, NE 68198, USA
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PCLiON: An Ontology for Data Standardization and Sharing of Prostate Cancer Associated Lifestyles. Int J Med Inform 2020; 145:104332. [PMID: 33186790 DOI: 10.1016/j.ijmedinf.2020.104332] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Researches on Lifestyle medicine (LM) have emerged in recent years to garner wide attention. Prostate cancer (PCa) could be prevented and treated by positive lifestyles, but the association between lifestyles and PCa is always personalized. OBJECTIVES In order to solve the heterogeneity and diversity of different data types related to PCa, establish a standardized lifestyle ontology, promote the exchange and sharing of disease lifestyle knowledge, and support text mining and knowledge discovery. METHODS The overall construction of PCLiON was created in accordance with the principles and methodology of ontology construction. Following the principles of evidence-based medicine, we screened and integrated the lifestyles and their related attributes. Protégé was used to construct and validate the semantic framework. All annotations in PCLiON were based on SNOMED CT, NCI Thesaurus, the Cochrane Library and FooDB, etc. HTML5 and ASP.NET was used to develop the independent Web page platform and corresponding intelligent terminal application. The PCLiON also uploaded to the National Center for Biomedical Ontology BioPortal. RESULTS PCLiON integrates 397 lifestyles and lifestyle-related factors associated with PCa, and is the first of its kind for a specific disease. It contains 320 attribute annotations and 11 object attributes. The logical relationship and completeness meet the ontology requirements. Qualitative analysis was carried out for 329 terms in PCLiON, including factors which are protective, risk or associated but functional unclear, etc. PCLiON is publicly available both at http://pcaontology.net/PCaLifeStyleDefault.aspx and https://bioportal.bioontology.org/ontologies/PCALION. CONCLUSIONS Through the bilingual online platforms, complex lifestyle research data can be transformed into standardized, reliable and responsive knowledge, which can promote the shared-decision making (SDM) on lifestyle intervention and assist patients in lifestyle self-management toward the goal of PCa targeted prevention.
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Alcohol Consumption and the Risk of Prostate Cancer: A Dose-Response Meta-Analysis. Nutrients 2020; 12:nu12082188. [PMID: 32717903 PMCID: PMC7468718 DOI: 10.3390/nu12082188] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 01/06/2023] Open
Abstract
Alcohol is widely consumed and is known as a major risk factor for several types of cancers. Yet, it is unclear whether alcohol consumption is associated with the risk of prostate cancer (PCa) or not. We conducted linear and non-linear dose–response meta-analyses of cohort studies on alcohol consumption and PCa risk by types of alcohol (total, wine, beer, and liquor) and PCa (non-aggressive and aggressive). Pubmed and Embase were searched through April 2020 to identify relevant studies. Summary relative risk (RR) and 95% confidence interval (CI) were estimated using a random-effects model. For non-aggressive PCa, by alcohol type, the risk increased linearly with liquor (RR per 14 g/day intake (alcohol content in standard drink) being 1.04 (95% CI = 1.02–1.06, I2 = 0%, three studies) and non-linearly with beer (Pnon-linearity = 0.045, four studies), with increased risk observed in the lower range (RR = 1.03, 95% CI = 1.01–1.05; 14 g/day), with 1.05 (95% CI = 1.01–1.08) at 28 g/day. Wine was not significantly associated with the risk of non-aggressive PCa. For aggressive PCa, a non-linear relationship of diverse shapes was indicated for all types of alcohol in the sensitivity analysis. Compared to non-drinking, a significant positive association was more apparent at lower dose for liquor (RR = 1.12, 95% CI = 1.04–1.20 at 14 g/day; RR = 1.16, 95% CI = 1.03–1.31 at 28 g/day; Pnon-linearity = 0.005, three studies) but at higher doses for wine (RR = 1.02, 95% CI = 0.90–1.16 at 28 g/day, RR = 1.35, 95% CI = 1.08–1.67 at 56 g/day; Pnon-linearity = 0.01, four studies). In contrast, decreased risks were indicated at lower doses of beer (RR = 0.85, 95% CI = 0.79–0.92 at 14 g/day; RR = 0.79, 95% CI = 0.70–0.90 at 28 g/day, Pnon-linearity < 0.001, four studies). Total alcohol consumption was not associated with both types of PCa. In this study, we found heterogeneous associations between alcohol intake and PCa by types of alcohol and PCa.
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Downer MK, Kenfield SA, Stampfer MJ, Wilson KM, Dickerman BA, Giovannucci EL, Rimm EB, Wang M, Mucci LA, Willett WC, Chan JM, Van Blarigan EL. Alcohol Intake and Risk of Lethal Prostate Cancer in the Health Professionals Follow-Up Study. J Clin Oncol 2019; 37:1499-1511. [PMID: 31026211 PMCID: PMC6599404 DOI: 10.1200/jco.18.02462] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE It is unknown whether alcohol intake is associated with the risk of lethal (metastatic or fatal) prostate cancer. We examine (1) whether alcohol intake among men at risk of prostate cancer is associated with diagnosis of lethal prostate cancer and (2) whether intake among men with nonmetastatic prostate cancer is associated with metastasis or death. METHODS This prospective cohort study uses the Health Professionals Follow-Up Study (1986 to 2012). Our analysis of alcohol intake among men at risk of prostate cancer included 47,568 cancer-free men. Our analysis of alcohol intake among men with prostate cancer was restricted to 5,182 men diagnosed with nonmetastatic prostate cancer during follow-up. We examine the association of total alcohol, red and white wine, beer, and liquor with lethal prostate cancer and death. Multivariate Cox proportional hazards regression estimated hazard ratios (HRs) and 95% CIs. RESULTS Alcohol drinkers had a lower risk of lethal prostate cancer (any v none: HR, 0.84 [95% CI, 0.71 to 0.99]) without a dose-response relationship. Total alcohol intake among patients with prostate cancer was not associated with progression to lethal prostate cancer (any v none: HR, 0.99 [95% CI, 0.57 to 1.72]), whereas moderate red wine intake was associated with a lower risk (any v none: HR, 0.50 [95% CI, 0.29 to 0.86]; P trend = .05). Compared with none, 15 to 30 g/d of total alcohol after prostate cancer diagnosis was associated with a lower risk of death (HR, 0.71 [95% CI, 0.50 to 1.00]), as was red wine (any v none: HR, 0.74 [95% CI, 0.57 to 0.97]; P trend = .007). CONCLUSION Cancer-free men who consumed alcohol had a slightly lower risk of lethal prostate cancer compared with abstainers. Among men with prostate cancer, red wine was associated with a lower risk of progression to lethal disease. These observed associations merit additional study but provide assurance that moderate alcohol consumption is safe for patients with prostate cancer.
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Affiliation(s)
- Mary K. Downer
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Stacey A. Kenfield
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- University of California, San Francisco, San Francisco, CA
| | - Meir J. Stampfer
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kathryn M. Wilson
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | - Edward L. Giovannucci
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric B. Rimm
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Molin Wang
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lorelei A. Mucci
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - June M. Chan
- University of California, San Francisco, San Francisco, CA
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Bellamri M, Turesky RJ. Dietary Carcinogens and DNA Adducts in Prostate Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1210:29-55. [PMID: 31900903 DOI: 10.1007/978-3-030-32656-2_2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prostate cancer (PC) is the most commonly diagnosed non-cutaneous cancer and the second leading cause of cancer-related to death in men. The major risk factors for PC are age, family history, and African American ethnicity. Epidemiological studies have reported large geographical variations in PC incidence and mortality, and thus lifestyle and dietary factors influence PC risk. High fat diet, dairy products, alcohol and red meats, are considered as risk factors for PC. This book chapter provides a comprehensive, literature-based review on dietary factors and their molecular mechanisms of prostate carcinogenesis. A large portion of our knowledge is based on epidemiological studies where dietary factors such as cancer promoting agents, including high-fat, dairy products, alcohol, and cancer-initiating genotoxicants formed in cooked meats have been evaluated for PC risk. However, the precise mechanisms in the etiology of PC development remain uncertain. Additional animal and human cell-based studies are required to further our understandings of risk factors involved in PC etiology. Specific biomarkers of chemical exposures and DNA damage in the prostate can provide evidence of cancer-causing agents in the prostate. Collectively, these studies can improve public health research, nutritional education and chemoprevention strategies.
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Affiliation(s)
- Medjda Bellamri
- Department of Medicinal Chemistry, Cancer and Cardiovascular Research Building, University of Minnesota, Minneapolis, MN, USA.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Robert J Turesky
- Department of Medicinal Chemistry, Cancer and Cardiovascular Research Building, University of Minnesota, Minneapolis, MN, USA. .,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
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Vartolomei MD, Kimura S, Ferro M, Foerster B, Abufaraj M, Briganti A, Karakiewicz PI, Shariat SF. The impact of moderate wine consumption on the risk of developing prostate cancer. Clin Epidemiol 2018; 10:431-444. [PMID: 29713200 PMCID: PMC5909789 DOI: 10.2147/clep.s163668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective To investigate the impact of moderate wine consumption on the risk of prostate cancer (PCa). We focused on the differential effect of moderate consumption of red versus white wine. Design This study was a meta-analysis that includes data from case–control and cohort studies. Materials and methods A systematic search of Web of Science, Medline/PubMed, and Cochrane library was performed on December 1, 2017. Studies were deemed eligible if they assessed the risk of PCa due to red, white, or any wine using multivariable logistic regression analysis. We performed a formal meta-analysis for the risk of PCa according to moderate wine and wine type consumption (white or red). Heterogeneity between studies was assessed using Cochrane’s Q test and I2 statistics. Publication bias was assessed using Egger’s regression test. Results A total of 930 abstracts and titles were initially identified. After removal of duplicates, reviews, and conference abstracts, 83 full-text original articles were screened. Seventeen studies (611,169 subjects) were included for final evaluation and fulfilled the inclusion criteria. In the case of moderate wine consumption: the pooled risk ratio (RR) for the risk of PCa was 0.98 (95% CI 0.92–1.05, p=0.57) in the multivariable analysis. Moderate white wine consumption increased the risk of PCa with a pooled RR of 1.26 (95% CI 1.10–1.43, p=0.001) in the multi-variable analysis. Meanwhile, moderate red wine consumption had a protective role reducing the risk by 12% (RR 0.88, 95% CI 0.78–0.999, p=0.047) in the multivariable analysis that comprised 222,447 subjects. Conclusions In this meta-analysis, moderate wine consumption did not impact the risk of PCa. Interestingly, regarding the type of wine, moderate consumption of white wine increased the risk of PCa, whereas moderate consumption of red wine had a protective effect. Further analyses are needed to assess the differential molecular effect of white and red wine conferring their impact on PCa risk.
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Affiliation(s)
- Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shoji Kimura
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Beat Foerster
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Alberto Briganti
- Department of Urology, Vita Salute San Raffaele University, Milan, Italy
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Weill Cornell Medical College, New York, NY, USA
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10
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Wilsnack RW, Wilsnack SC, Gmel G, Kantor LW. Gender Differences in Binge Drinking. Alcohol Res 2018; 39:57-76. [PMID: 30557149 PMCID: PMC6104960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Just as binge drinking rates differ for men and women, the predictors and consequences of binge drinking vary by gender as well. This article examines these differences and how binge drinking definitions and research samples and methods may influence findings. It also describes the relationship between age and binge drinking among men and women, and how drinking culture and environment affect this relationship. It examines gender-specific trends in binge drinking, predictors of binge drinking for men and women, and binge drinking in the context of smoking. The article reviews current findings on gender differences in the health consequences of binge drinking, including morbidity and mortality, suicidality, cancer, cardiovascular disorders, liver disorders, and brain and neurocognitive implications. It also discusses gender differences in the behavioral and social consequences of binge drinking, including alcohol-impaired driving, sexual assault, and intimate partner violence, and includes implications for treatment and prevention.
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Affiliation(s)
- Richard W Wilsnack
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Sharon C Wilsnack
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Gerhard Gmel
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
| | - Lori Wolfgang Kantor
- Richard W. Wilsnack, Ph.D., is a professor emeritus in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Sharon C. Wilsnack, Ph.D., is the Chester Fritz Distinguished Professor in the Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota. Gerhard Gmel, Ph.D., is a professor, University of Lausanne, and is affiliated with the Alcohol Treatment Center, University of Lausanne Hospital, Lausanne, Switzerland. He is also an invited professor, University of the West of England, Bristol, United Kingdom. Lori Wolfgang Kantor, M.A., is a science writer at CSR, Incorporated
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11
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Is there a relationship between adverse childhood experiences and problem drinking behaviors? Findings from a population-based sample. Public Health 2017. [DOI: 10.1016/j.puhe.2017.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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12
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Wei W, Zeng G, Liu C, Zou B, Li L. Associations of LIM kinase1 (LIMK1) gene single nucleotide polymorphisms with prostate cancer susceptibility in Chinese population. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:9725-9734. [PMID: 31966855 PMCID: PMC6965917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/20/2017] [Indexed: 06/10/2023]
Abstract
BACKGROUND Prostate cancer is one of the most common cancers in men. LIM kinase1 (LIMK1) is a mediator in the process of cytoskeleton reorganization and cell motility. LIMK1 is related to progression, invasiveness and metastases of prostate cancer. However, the relationship between LIMK1 single nucleotide polymorphism (SNP) and the risk of prostate cancer has not been studied. AIM The aim of our study is to determine the association between LIMK1 polymorphisms and the risk of prostate in a Chinese population. METHODS This case-control study consisted of 162 prostate cancer patients and 187 healthy control subjects. Five SNPs of LIMK1 including rs2269082, rs2269081, rs178409, rs6460071 and rs710968 were genotyped using iPLEX genotyping assays on a MassARRAY® platform. RESULTS No significant relationships were found between polymorphisms genotypes and the risk of prostate cancer. Also, no significant associations were found between genotypes and the individual factors such as Gleason Score, alcohol and cigarette consuming statuses. CONCLUSION These polymorphisms of LIMK1 were not significantly associated with prostate cancer susceptibility in Chinese men.
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Affiliation(s)
- Wuran Wei
- Institute of Urology, Department of Urology, West China Hospital, Sichuan UniversityChengdu, China
| | - Guojun Zeng
- Department of Vascular Surgery, West China Hospital, Sichuan UniversityChengdu, China
| | - Chang Liu
- Department of Liver Surgery, West China Hospital, Sichuan UniversityChengdu, China
| | - Bingwen Zou
- Department of Oncology, West China Hospital, Sichuan UniversityChengdu, China
| | - Li Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of EducationChengdu, China
- Department of Pediatrics, West China Second University Hospital, Sichuan UniversityChengdu, China
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13
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Saha SK, Lee SB, Won J, Choi HY, Kim K, Yang GM, Dayem AA, Cho SG. Correlation between Oxidative Stress, Nutrition, and Cancer Initiation. Int J Mol Sci 2017; 18:E1544. [PMID: 28714931 PMCID: PMC5536032 DOI: 10.3390/ijms18071544] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 02/07/2023] Open
Abstract
Inadequate or excessive nutrient consumption leads to oxidative stress, which may disrupt oxidative homeostasis, activate a cascade of molecular pathways, and alter the metabolic status of various tissues. Several foods and consumption patterns have been associated with various cancers and approximately 30-35% of the cancer cases are correlated with overnutrition or malnutrition. However, several contradictory studies are available regarding the association between diet and cancer risk, which remains to be elucidated. Concurrently, oxidative stress is a crucial factor for cancer progression and therapy. Nutritional oxidative stress may be induced by an imbalance between antioxidant defense and pro-oxidant load due to inadequate or excess nutrient supply. Oxidative stress is a physiological state where high levels of reactive oxygen species (ROS) and free radicals are generated. Several signaling pathways associated with carcinogenesis can additionally control ROS generation and regulate ROS downstream mechanisms, which could have potential implications in anticancer research. Cancer initiation may be modulated by the nutrition-mediated elevation in ROS levels, which can stimulate cancer initiation by triggering DNA mutations, damage, and pro-oncogenic signaling. Therefore, in this review, we have provided an overview of the relationship between nutrition, oxidative stress, and cancer initiation, and evaluated the impact of nutrient-mediated regulation of antioxidant capability against cancer therapy.
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Affiliation(s)
- Subbroto Kumar Saha
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Soo Bin Lee
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Jihye Won
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Hye Yeon Choi
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Kyeongseok Kim
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Gwang-Mo Yang
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Ahmed Abdal Dayem
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
| | - Ssang-Goo Cho
- Department of Stem Cell and Regenerative Biotechnology, Incurable Disease Animal Model & Stem Cell Institute (IDASI), Konkuk University, Seoul 05029, Korea.
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14
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Total and beverage-specific alcohol intake and the risk of aggressive prostate cancer: a case-control study. Prostate Cancer Prostatic Dis 2017; 20:305-310. [PMID: 28417982 DOI: 10.1038/pcan.2017.12] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/20/2017] [Accepted: 02/10/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Ethanol in alcoholic beverages is a known carcinogen, but its association with aggressive prostate cancer (APC) is uncertain. Recent studies have shown a modest increase in risk of APC associated with heavy alcohol intake while association for beverage types remain inconsistent. METHODS Using a case-control design and self-administered questionnaire, we examined the association between APC (high grade and/or advanced stage) and frequency and quantity of alcohol intake 2 years prior to enrolment. Furthermore, we delineated the relationships for beverage-specific intakes of beer, red wine, white wine and spirits. RESULTS The study included 1282 APC cases and 951 controls. Beer intake frequency of ⩾5 days per week was associated with increased risk compared with no beer intake (odds ratio=1.66, 95% confidence interval: 1.12-2.48) whereas wine was protective at all frequencies of consumption compared with those with no wine intake. For every 10 g per week ethanol intake from beer increase, the odds of advanced PC rose by 3% (OR=1.03, 95% CI: 1.02-1.05). No such increased risk was observed for red or white wine while a marginal dose-response relationship was found for spirits (OR=1.03, 95% CI: 0.99-1.07). CONCLUSIONS Heavy beer and possibly spirits consumption is associated with increased risk while no dose-response relationship was found for red or white wine. Wine drinkers at all frequencies have a decreased risk of APC compared with those who did not drink wine.
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15
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Brunner C, Davies NM, Martin RM, Eeles R, Easton D, Kote‐Jarai Z, Al Olama AA, Benlloch S, Muir K, Giles G, Wiklund F, Gronberg H, Haiman CA, Schleutker J, Nordestgaard BG, Travis RC, Neal D, Donovan J, Hamdy FC, Pashayan N, Khaw K, Stanford JL, Blot WJ, Thibodeau S, Maier C, Kibel AS, Cybulski C, Cannon‐Albright L, Brenner H, Park J, Kaneva R, Batra J, Teixeira MR, Pandha H, Zuccolo L. Alcohol consumption and prostate cancer incidence and progression: A Mendelian randomisation study. Int J Cancer 2017; 140:75-85. [PMID: 27643404 PMCID: PMC5111609 DOI: 10.1002/ijc.30436] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/04/2016] [Accepted: 07/29/2016] [Indexed: 12/25/2022]
Abstract
Prostate cancer is the most common cancer in men in developed countries, and is a target for risk reduction strategies. The effects of alcohol consumption on prostate cancer incidence and survival remain unclear, potentially due to methodological limitations of observational studies. In this study, we investigated the associations of genetic variants in alcohol-metabolising genes with prostate cancer incidence and survival. We analysed data from 23,868 men with prostate cancer and 23,051 controls from 25 studies within the international PRACTICAL Consortium. Study-specific associations of 68 single nucleotide polymorphisms (SNPs) in 8 alcohol-metabolising genes (Alcohol Dehydrogenases (ADHs) and Aldehyde Dehydrogenases (ALDHs)) with prostate cancer diagnosis and prostate cancer-specific mortality, by grade, were assessed using logistic and Cox regression models, respectively. The data across the 25 studies were meta-analysed using fixed-effect and random-effects models. We found little evidence that variants in alcohol metabolising genes were associated with prostate cancer diagnosis. Four variants in two genes exceeded the multiple testing threshold for associations with prostate cancer mortality in fixed-effect meta-analyses. SNPs within ALDH1A2 associated with prostate cancer mortality were rs1441817 (fixed effects hazard ratio, HRfixed = 0.78; 95% confidence interval (95%CI):0.66,0.91; p values = 0.002); rs12910509, HRfixed = 0.76; 95%CI:0.64,0.91; p values = 0.003); and rs8041922 (HRfixed = 0.76; 95%CI:0.64,0.91; p values = 0.002). These SNPs were in linkage disequilibrium with each other. In ALDH1B1, rs10973794 (HRfixed = 1.43; 95%CI:1.14,1.79; p values = 0.002) was associated with prostate cancer mortality in men with low-grade prostate cancer. These results suggest that alcohol consumption is unlikely to affect prostate cancer incidence, but it may influence disease progression.
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Affiliation(s)
- Clair Brunner
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
- MRC/University of Bristol Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom
| | - Neil M. Davies
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
- MRC/University of Bristol Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom
| | - Richard M. Martin
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
- MRC/University of Bristol Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom
- The NIHR Bristol Nutrition Biomedical Research UnitUniversity Hospitals Bristol NHS Foundation Trust and the University of BristolBristolUnited Kingdom
| | - Rosalind Eeles
- The Institute of Cancer ResearchLondonSM2 5NGUnited Kingdom
- Royal Marsden NHS Foundation TrustLondonSW3 6JJUnited Kingdom
| | - Doug Easton
- Strangeways Laboratory, Department of Public Health and Primary CareCentre for Cancer Genetic Epidemiology, University of CambridgeWorts CausewayCambridgeUnited Kingdom
| | | | - Ali Amin Al Olama
- Strangeways Laboratory, Department of Public Health and Primary CareCentre for Cancer Genetic Epidemiology, University of CambridgeWorts CausewayCambridgeUnited Kingdom
| | - Sara Benlloch
- Strangeways Laboratory, Department of Public Health and Primary CareCentre for Cancer Genetic Epidemiology, University of CambridgeWorts CausewayCambridgeUnited Kingdom
| | - Kenneth Muir
- Institute of Population Health, University of ManchesterManchesterUnited Kingdom
| | - Graham Giles
- The Cancer Council VictoriaCancer Epidemiology Centre1 Rathdowne StreetCarltonVicAustralia
- Centre for Molecular, Environmental, Genetic and Analytic EpidemiologyThe University of MelbourneVicAustralia
| | - Fredrik Wiklund
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | - Henrik Gronberg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California/Norris Comprehensive Cancer CenterLos AngelesCA
| | - Johanna Schleutker
- Department of Medical Biochemistry and GeneticsUniversity of TurkuTurkuFinland
- Institute of Biomedical Technology/BioMediTech, University of Tampere and FimLab LaboratoriesTampereFinland
| | - Børge G. Nordestgaard
- Department of Clinical BiochemistryHerlev Hospital, Copenhagen University HospitalHerlev Ringvej 75DK‐2730HerlevDenmark
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Clinical MedicineUniversity of OxfordOxfordUnited Kingdom
| | - David Neal
- Surgical Oncology (Uro‐Oncology: S4)University of Cambridge, Box 279, Addenbrooke's HospitalHills RoadCambridgeUnited Kingdom
- Cancer Research UK Cambridge Research Institute, Li Ka Shing CentreCambridgeUnited Kingdom
| | - Jenny Donovan
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
| | - Freddie C. Hamdy
- Nuffield Department of SurgeryUniversity of OxfordOxfordUnited Kingdom
| | - Nora Pashayan
- Strangeways Laboratory, Department of OncologyCentre for Cancer Genetic Epidemiology, University of CambridgeWorts CausewayCambridgeUnited Kingdom
- Department of Applied Health ResearchUniversity College London1‐19 Torrington PlaceLondonWC1E 7HBUnited Kingdom
| | - Kay‐Tee Khaw
- Cambridge Institute of Public Health, University of CambridgeForvie SiteRobinson WayCambridgeCB2 0SRUnited Kingdom
| | - Janet L. Stanford
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWA
- Department of Epidemiology, School of Public HealthUniversity of WashingtonSeattleWA
| | - William J. Blot
- International Epidemiology Institute1455 Research Blvd, Suite 550RockvilleMD
| | | | - Christiane Maier
- Department of UrologyUniversity Hospital UlmGermany
- Institute of Human Genetics University Hospital UlmGermany
| | - Adam S. Kibel
- Brigham and Women's Hospital/Dana‐Farber Cancer Institute45 Francis Street‐ASB II‐3BostonMA
- Washington UniversitySt LouisMO
| | - Cezary Cybulski
- Department of Genetics and PathologyInternational Hereditary Cancer Center, Pomeranian Medical UniversitySzczecinPoland
| | - Lisa Cannon‐Albright
- Division of Genetic Epidemiology, Department of MedicineUniversity of Utah School of Medicine, Salt Lake City, UT
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging ResearchGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Division of Preventive OncologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ)Heidelberg, Germany
| | - Jong Park
- Division of Cancer Prevention and ControlH. Lee Moffitt Cancer Center12902 Magnolia DrTampaFL
| | - Radka Kaneva
- Department of Medical Chemistry and Biochemistry, Molecular Medicine CenterMedical University Sofia2 Zdrave StSofia1431Bulgaria
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre‐Qld, Institute of Health and Biomedical Innovation and Schools of Life Science and Public Health, Queensland University of TechnologyBNEAustralia
| | - Manuel R. Teixeira
- Department of GeneticsPortuguese Oncology Institute, Porto, Portugal and Biomedical Sciences Institute (ICBAS), Porto UniversityPortoPortugal
| | - Hardev Pandha
- The University of SurreyGuildfordSurreyGU2 7XHUnited Kingdom
| | | | - Luisa Zuccolo
- School of Social and Community MedicineUniversity of BristolBristolUnited Kingdom
- MRC/University of Bristol Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom
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16
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Markozannes G, Tzoulaki I, Karli D, Evangelou E, Ntzani E, Gunter MJ, Norat T, Ioannidis JP, Tsilidis KK. Diet, body size, physical activity and risk of prostate cancer: An umbrella review of the evidence. Eur J Cancer 2016; 69:61-69. [PMID: 27816833 DOI: 10.1016/j.ejca.2016.09.026] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/15/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022]
Abstract
The existing literature on the relationship between diet, body size, physical activity and prostate cancer risk was summarised by the World Cancer Research Fund Continuous Update Project (CUP). An evaluation of the robustness of this evidence is required to help inform public health policy. The robustness of this evidence was evaluated using several criteria addressing evidence strength and validity, including the statistical significance of the random effects summary estimate and of the largest study in a meta-analysis, number of prostate cancer cases, between-study heterogeneity, 95% prediction intervals, small-study effects bias, excess significance bias and sensitivity analyses with credibility ceilings. A total of 248 meta-analyses were extracted from the CUP, which studied associations of 23 foods, 31 nutrients, eight indices of body size and three indices of physical activity with risk of total prostate cancer development, mortality or cancer development by stage and grade. Of the 176 meta-analyses using a continuous scale to measure the exposures, no association presented strong evidence by satisfying all the aforementioned criteria. Only the association of height with total prostate cancer incidence and mortality presented highly suggestive evidence with a 4% higher risk per 5 cm greater height (95% confidence interval, 1.03, 1.05). Associations for body mass index, weight, height, dietary calcium and spirits intake were supported by suggestive evidence. Overall, the association of diet, body size, physical activity and prostate cancer has been extensively studied, but no association was graded with strong evidence.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Dimitra Karli
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece; Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, 121 South Main Street, Providence, RI, 02903, USA
| | - Marc J Gunter
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - John P Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA, 94305, USA; Department of Health Research and Policy, Stanford School of Medicine, Stanford, CA, 94305, USA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, 94305, USA
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Stavros Niarchos Av., University Campus, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
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17
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Zhao J, Stockwell T, Roemer A, Chikritzhs T. Is alcohol consumption a risk factor for prostate cancer? A systematic review and meta-analysis. BMC Cancer 2016; 16:845. [PMID: 27842506 PMCID: PMC5109713 DOI: 10.1186/s12885-016-2891-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive. Recent studies on associations between alcohol consumption and other health outcomes suggest these are influenced by drinker misclassification errors and other study quality characteristics. The influence of these factors on estimates of the relationship between alcohol consumption and prostate cancer has not been previously investigated. METHODS PubMed and Web of Science searches were made for case-control and cohort studies of alcohol consumption and prostate cancer morbidity and mortality (ICD-10: C61) up to December 2014. Studies were coded for drinker misclassification errors, quality of alcohol measures, extent of control for confounding and other study characteristics. Mixed models were used to estimate relative risk (RR) of morbidity or mortality from prostate cancer due to alcohol consumption with study level controls for selection bias and confounding. RESULTS A total of 340 studies were identified of which 27 satisfied inclusion criteria providing 126 estimates for different alcohol exposures. Adjusted RR estimates indicated a significantly increased risk of prostate cancer among low (RR = 1.08, P < 0.001), medium (RR = 1.07, P < 0.01), high (RR = 1.14, P < 0.001) and higher (RR = 1.18, P < 0.001) volume drinkers compared to abstainers. There was a significant dose-response relationship for current drinkers (Ptrend < 0.01). Studies free from misclassification errors produced the highest risk estimates for drinkers versus abstainers in adjusted models (RR = 1.22, P < 0.05). CONCLUSION Our study finds, for the first time, a significant dose-response relationship between level of alcohol intake and risk of prostate cancer starting with low volume consumption (>1.3, <24 g per day). This relationship is stronger in the relatively few studies free of former drinker misclassification error. Given the high prevalence of prostate cancer in the developed world, the public health implications of these findings are significant. Prostate cancer may need to be incorporated into future estimates of the burden of disease alongside other cancers (e.g. breast, oesophagus, colon, liver) and be integrated into public health strategies for reducing alcohol related disease.
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Affiliation(s)
- Jinhui Zhao
- Centre for Addictions Research of British Columbia, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8Y 2E4 Canada
| | - Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8Y 2E4 Canada
- Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8Y 2E4 Canada
| | - Audra Roemer
- Centre for Addictions Research of British Columbia, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8Y 2E4 Canada
- Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8Y 2E4 Canada
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, GPO box U1987, Perth, 6845 WA Australia
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Demoury C, Karakiewicz P, Parent ME. Association between lifetime alcohol consumption and prostate cancer risk: A case-control study in Montreal, Canada. Cancer Epidemiol 2016; 45:11-17. [PMID: 27664387 DOI: 10.1016/j.canep.2016.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/24/2016] [Accepted: 09/12/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Alcohol intake may increase the risk of prostate cancer (PCa). Many previous studies harbored important methodological limitations. METHODS We conducted a population-based case-control study of PCa comprising 1933 cases and 1994 controls in Montreal, Canada. Lifetime alcohol consumption was elicited, by type of beverage, during in-person interviews. Odds ratios (OR) and 95% confidence intervals (CI) assessed the association between alcohol intake and PCa risk, adjusting for potential confounders and considering the subjects' PCa screening history. RESULTS We observed a weak, non-significant positive association between high consumption of total alcohol over the lifetime and risk of high-grade PCa (OR=1.18, 95% CI 0.81-1.73). Risk estimates were more pronounced among current drinkers (OR=1.40, 95%CI 1.00-1.97), particularly after adjusting for the timing of last PCa screening (OR=1.52, 95%CI 1.07-2.16). These associations were largely driven by beer consumption. The OR for high-grade PCa associated with high beer intake was 1.37 (95%CI 1.00-1.89); it was 1.49 (95%CI 0.99-2.23) among current drinkers and 1.68 (95% CI 1.10-2.57) after adjusting for screening recency. High cumulative consumption of spirits was associated with a lower risk of low-grade PCa (OR=0.75, 95%CI 0.60-0.94) but the risk estimate no longer achieved statistical significance when restricting to current users. No association was found for wine consumption. CONCLUSION Findings add to the accumulating evidence that high alcohol consumption increases the risk of high-grade PCa. This association largely reflected beer intake in our population, and was strengthened when taking into account PCa screening history.
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Affiliation(s)
- Claire Demoury
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, University of Québec, 531 boul. des Prairies, Laval, QC, H7V 1B7, Canada.
| | - Pierre Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, 1058 Saint-Denis, Montréal, Québec, H2X 3J4, Canada; Department of Urology, University of Montreal Health Center, 264 René-Lévesque Est, room 500, Montréal, Québec, H2X 1P1, Canada.
| | - Marie-Elise Parent
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Institut national de la recherche scientifique, University of Québec, 531 boul. des Prairies, Laval, QC, H7V 1B7, Canada; School of Public Health, Department of Social and Preventive Medicine, University of Montreal, 7101 avenue du Parc, 3rd floor, Montréal, Québec, H3N 1X9, Canada; University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, Tour Viger, Pavillon R, Montréal, Québec, H2X 0A9, Canada.
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Dickerman BA, Markt SC, Koskenvuo M, Pukkala E, Mucci LA, Kaprio J. Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins. Cancer Causes Control 2016; 27:1049-58. [PMID: 27351919 PMCID: PMC5278639 DOI: 10.1007/s10552-016-0778-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/10/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Alcohol intake may be associated with cancer risk, but epidemiologic evidence for prostate cancer is inconsistent. We aimed to prospectively investigate the association between midlife alcohol intake and drinking patterns with future prostate cancer risk and mortality in a population-based cohort of Finnish twins. METHODS Data were drawn from the Older Finnish Twin Cohort and included 11,372 twins followed from 1981 to 2012. Alcohol consumption was assessed by questionnaires administered at two time points over follow-up. Over the study period, 601 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between weekly alcohol intake and binge drinking patterns with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were performed to control for potential confounding by shared genetic and early environmental factors. RESULTS Compared to light drinkers (≤3 drinks/week; non-abstainers), heavy drinkers (>14 drinks/week) were at a 1.46-fold higher risk (HR 1.46; 95 % CI 1.12, 1.91) of prostate cancer, adjusting for important confounders. Among current drinkers, binge drinkers were at a significantly increased risk of prostate cancer (HR 1.28; 95 % CI 1.06, 1.55) compared to non-binge drinkers. Abstainers were at a 1.90-fold higher risk (HR 1.90; 95 % CI 1.04, 3.47) of prostate cancer-specific mortality compared to light drinkers, but no other significant associations for mortality were found. Co-twin analyses suggested that alcohol consumption may be associated with prostate cancer risk independent of early environmental and genetic factors. CONCLUSION Heavy regular alcohol consumption and binge drinking patterns may be associated with increased prostate cancer risk, while abstinence may be associated with increased risk of prostate cancer-specific mortality compared to light alcohol consumption.
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Affiliation(s)
- Barbra A Dickerman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah Coseo Markt
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Markku Koskenvuo
- Department of Public Health, University of Helsinki, Mannerheimintie 172, P.O. Box 41, 00014, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Unioninkatu 22, 00130, Helsinki, Finland
- School of Health Sciences, University of Tampere, 33014, Tampere, Finland
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Mannerheimintie 172, P.O. Box 41, 00014, Helsinki, Finland.
- Department of Health, National Institute for Health and Welfare, Mannerheimintie 166, P.O. Box 30, 00300, Helsinki, Finland.
- Institute for Molecular Medicine (FIMM), University of Helsinki, Tukholmankatu 8, P.O. Box 20, 00014, Helsinki, Finland.
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20
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Effects of Smoking, Alcohol, and Exercise on Prostate Cancer. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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21
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Effects of Alcohol on Tumor Growth, Metastasis, Immune Response, and Host Survival. Alcohol Res 2015; 37:311-22. [PMID: 26695753 PMCID: PMC4590626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Most research involving alcohol and cancer concerns the relationship between alcohol consumption and cancer risk and the mechanisms of carcinogenesis. This review relates the amount and duration of alcohol intake in humans and in animal models of cancer to tumor growth, angiogenesis, invasion, metastasis, immune response, and host survival in specific types and subtypes of cancer. Research on the influence of alcohol drinking on human cancer patients is limited. Although there is more information in animal models of cancer, many aspects still are ill defined. More research is needed to define the mechanisms that underlie the role of alcohol on cancer progression in both animals and humans. Activation of the immune system can play a positive role in keeping cancer under control, but this also can facilitate cancer progression. Additionally, a functional immune system is required for cancer patients to achieve an optimal response to conventional chemotherapy. Insight into the underlying mechanisms of these interactions could lead to effective immunotherapeutic approaches to treat alcoholics with cancer. Defining the epigenetic mechanisms that modulate cancer progression also has great potential for the development of new treatment options not only for treating alcoholics with cancer but also for treating other alcohol-induced diseases.
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Fowke JH, Howard L, Andriole GL, Freedland SJ. Alcohol intake increases high-grade prostate cancer risk among men taking dutasteride in the REDUCE trial. Eur Urol 2014; 66:1133-8. [PMID: 24568894 DOI: 10.1016/j.eururo.2014.01.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/30/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although most studies found no association between alcohol intake and prostate cancer (PCa) risk, an analysis of the Prostate Cancer Prevention Trial found that high alcohol intake significantly increased PCa risk among men randomized to the 5α-reductase inhibitor (5-ARI) finasteride. OBJECTIVE Determine whether alcohol affects PCa risk among men taking the 5-ARI dutasteride. DESIGN, SETTINGS, AND PARTICIPANTS Reduction by Dutasteride of Prostate Cancer Events was a 4-yr, multicenter, randomized, double-blind, placebo-controlled trial to compare PCa after dutasteride administration (0.5mg/d) with placebo. Participants had a baseline prostate-specific antigen between 2.5 and 10.0 ng/ml and a recent negative prostate biopsy. Alcohol intake was determined by baseline questionnaire, and participants underwent a prostate biopsy to determine PCa status at 2 yr and 4 yr of follow-up. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between alcohol intake and low-grade (Gleason <7) and high-grade (Gleason >7) PCa. RESULTS AND LIMITATIONS Of 6374 participants in our analysis, approximately 25% reported no alcohol consumption, 49% were moderate drinkers (one to seven drinks per week), and 26% were heavy drinkers (more than seven drinks per week). Alcohol intake was not associated with low- or high-grade PCa in the placebo arm and was not associated with low-grade PCa among men taking dutasteride. In contrast, men randomized to dutasteride and reporting more than seven drinks per week were 86% more likely to be diagnosed with high-grade PCa (p=0.01). Among alcohol abstainers, dutasteride was associated with significantly reduced risk of high-grade PCa (OR: 0.59; 95% CI, 0.38-0.90), but dutasteride was no longer associated with reduced high-grade PCa among men reporting high alcohol intake (OR: 0.99; 95% CI, 0.67-1.45). CONCLUSIONS Alcohol consumption negated a protective association between dutasteride and high-grade PCa. PATIENT SUMMARY We confirmed a prior study that alcohol affects PCa prevention in patients taking 5-ARIs. Patients taking 5-ARIs may wish to eliminate alcohol intake if they are concerned about PCa.
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Affiliation(s)
- Jay H Fowke
- Division of Epidemiology, Departments of Medicine and Department of Surgical Urology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Lauren Howard
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA; Urology Section, Veterans Affairs Medical Center, Durham, NC, USA
| | - Gerald L Andriole
- Division of Urology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Stephen J Freedland
- Urology Section, Veterans Affairs Medical Center, Durham, NC, USA; Duke Prostate Center, Division of Urology, Department of Surgery and Pathology, Duke University School of Medicine, Durham, NC, USA
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Predictive factors and management of rectal bleeding side effects following prostate cancer brachytherapy. Int J Radiat Oncol Biol Phys 2013; 86:842-7. [PMID: 23845840 DOI: 10.1016/j.ijrobp.2013.04.033] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/12/2013] [Accepted: 04/16/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE To report on the incidence, nature, and management of rectal toxicities following individual or combination brachytherapy following treatment for prostate cancer over a 17-year period. We also report the patient and treatment factors predisposing to acute ≥ grade 2 proctitis. METHODS AND MATERIALS A total of 2752 patients were treated for prostate cancer between October 1990 and April 2007 with either low-dose-rate brachytherapy alone or in combination with androgen depletion therapy (ADT) or external beam radiation therapy (EBRT) and were followed for a median of 5.86 years (minimum 1.0 years; maximum 19.19 years). We investigated the 10-year incidence, nature, and treatment of acute and chronic rectal toxicities following BT. Using univariate, and multivariate analyses, we determined the treatment and comorbidity factors predisposing to rectal toxicities. We also outline the most common and effective management for these toxicities. RESULTS Actuarial risk of ≥ grade 2 rectal bleeding was 6.4%, though notably only 0.9% of all patients required medical intervention to manage this toxicity. The majority of rectal bleeding episodes (72%) occurred within the first 3 years following placement of BT seeds. Of the 27 patients requiring management for their rectal bleeding, 18 underwent formalin treatment and nine underwent cauterization. Post-hoc univariate statistical analysis revealed that coronary artery disease (CAD), biologically effective dose, rectal volume receiving 100% of the prescription dose (RV100), and treatment modality predict the likelihood of grade ≥2 rectal bleeding. Only CAD, treatment type, and RV100 fit a Cox regression multivariate model. CONCLUSIONS Low-dose-rate prostate brachytherapy is very well tolerated and rectal bleeding toxicities are either self-resolving or effectively managed by medical intervention. Treatment planning incorporating adjuvant ADT while minimizing RV100 has yielded the best toxicity-free survival following BT.
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Sawada N, Inoue M, Iwasaki M, Sasazuki S, Yamaji T, Shimazu T, Tsugane S. Alcohol and smoking and subsequent risk of prostate cancer in Japanese men: the Japan Public Health Center-based prospective study. Int J Cancer 2013; 134:971-8. [PMID: 23929133 DOI: 10.1002/ijc.28423] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/22/2013] [Indexed: 11/12/2022]
Abstract
Although alcohol and smoking have not been established as risk factors for prostate cancer, they are important risk factors for other human cancers and potentially major avoidable factors. Alcohol drinkers and smokers might be less likely to get screening, which might lead to attenuation of the positive association. Here, we investigated the association of alcohol drinking and smoking and prostate cancer according to stage, as well as prostate cancer detected by subjective symptoms, in a large prospective study among Japanese men. The Japan Public Health Center-based prospective study (JPHC study) was established in 1990 for Cohort I and in 1993 for Cohort II. Subjects were 48,218 men aged 40-69 years who completed a questionnaire, which included their alcohol and smoking habits at baseline, and who were followed until the end of 2010. During 16 years of follow-up, 913 men were newly diagnosed with prostate cancer; of whom 248 had advanced cases, 635 were organ-localized and 30 were of an undetermined stage. Alcohol consumption was dose-dependently associated with advanced prostate cancer [nondrinkers: reference, 0-150 g/week: hazard ratio (HR) = 1.23, 95% confidence interval (CI) = 0.83-1.82; 150-300 g/week: HR = 1.51, 95% CI = 1.04-2.19; ≥ 300 g/week: HR = 1.41, 95% CI = 0.97-2.05, p for trend = 0.02]. The positive association was not substantially changed among cancers detected by subjective symptoms. Smoking was inversely associated with prostate cancer among total subjects, but tended to increase the risk of advanced prostate cancer detected by subjective symptoms. In conclusion, abstinence from alcohol and prohibition of smoking might be important factors in the prevention of advanced prostate cancer.
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Affiliation(s)
- Norie Sawada
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
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Zuccolo L, Lewis SJ, Donovan JL, Hamdy FC, Neal DE, Smith GD. Alcohol consumption and PSA-detected prostate cancer risk--a case-control nested in the ProtecT study. Int J Cancer 2013; 132:2176-85. [PMID: 23024014 PMCID: PMC3786564 DOI: 10.1002/ijc.27877] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 07/09/2012] [Indexed: 12/05/2022]
Abstract
Alcohol is an established carcinogen but not an established risk factor for prostate cancer, despite some recent prospective studies suggesting increased risk among heavy drinkers. The aim of this study was to investigate the role of alcohol on prostate-specific antigen (PSA) levels and prostate cancer risk. Two thousand four hundred PSA detected prostate cancer cases and 12,700 controls matched on age and general practice were identified through a case-control study nested in the PSA-testing phase of a large UK-based randomized controlled trial for prostate cancer treatment (ProtecT). Linear and multinomial logistic regression models were used to estimate ratios of geometric means (RGMs) of PSA and relative risk ratios (RRRs) of prostate cancer by stage and grade, with 95% confidence intervals (CIs), associated with weekly alcohol intake and drinking patterns. We found evidence of lower PSA (RGM 0.98, 95% CI: 0.98-0.99) and decreased risk of low Gleason-grade (RRR 0.96; 95%CI 0.93-0.99) but increased risk of high-grade prostate cancer (RRR 1.04; 95%CI 0.99-1.08; p(difference) =0.004) per 10 units/week increase in alcohol consumption, not explained by current BMI, blood pressure, comorbidities, or reverse causation. This is the first large population-based study to find evidence of lower PSA levels for increasing alcohol consumption, with potential public health implications for the detection of prostate cancer. Our results also support a modestly higher risk of high-grade disease for heavy drinkers, but require independent replication to establish the nature of the association of alcohol with low-grade disease, preferably in cohorts with a heterogeneous case-mix.
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Affiliation(s)
- Luisa Zuccolo
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom.
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26
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Nelson DE, Jarman DW, Rehm J, Greenfield TK, Rey G, Kerr WC, Miller P, Shield KD, Ye Y, Naimi TS. Alcohol-attributable cancer deaths and years of potential life lost in the United States. Am J Public Health 2013; 103:641-8. [PMID: 23409916 PMCID: PMC3673233 DOI: 10.2105/ajph.2012.301199] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2012] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Our goal was to provide current estimates of alcohol-attributable cancer mortality and years of potential life lost (YPLL) in the United States. METHODS We used 2 methods to calculate population-attributable fractions. We based relative risks on meta-analyses published since 2000, and adult alcohol consumption on data from the 2009 Alcohol Epidemiologic Data System, 2009 Behavioral Risk Factor Surveillance System, and 2009-2010 National Alcohol Survey. RESULTS Alcohol consumption resulted in an estimated 18,200 to 21,300 cancer deaths, or 3.2% to 3.7% of all US cancer deaths. The majority of alcohol-attributable female cancer deaths were from breast cancer (56% to 66%), whereas upper airway and esophageal cancer deaths were more common among men (53% to 71%). Alcohol-attributable cancers resulted in 17.0 to 19.1 YPLL for each death. Daily consumption of up to 20 grams of alcohol (≤ 1.5 drinks) accounted for 26% to 35% of alcohol-attributable cancer deaths. CONCLUSIONS Alcohol remains a major contributor to cancer mortality and YPLL. Higher consumption increases risk but there is no safe threshold for alcohol and cancer risk. Reducing alcohol consumption is an important and underemphasized cancer prevention strategy.
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Affiliation(s)
- David E Nelson
- National Cancer Institute, Bethesda, MD 20892-7105, USA.
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McGregor SE, Courneya KS, Kopciuk KA, Tosevski C, Friedenreich CM. Case-control study of lifetime alcohol intake and prostate cancer risk. Cancer Causes Control 2012; 24:451-61. [PMID: 23271409 DOI: 10.1007/s10552-012-0131-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 12/16/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Alcohol consumption may be a modifiable risk factor for prostate cancer, but previous results have been inconsistent and limited by a lack of data on lifetime exposure and specific beverages. Furthermore, the effect of tumor stage and severity of disease on the association between alcohol and prostate cancer risk has not been fully investigated. METHODS We examined the relation between both current and lifetime alcohol intake and prostate cancer risk in a population-based case-control study in Alberta, Canada with 947 cases with stage T2 and higher prostate cancer diagnosed between 1997 and 2000 and frequency matched to 1,039 controls, identified through random digit dialing. Cases were classified on cancer stage and severity into 619 non-aggressive (Stage II and Gleason score <8) and 328 aggressive cases (Stage III/IV or Gleason score ≥8). In-person interviews were completed on current and lifetime history of alcohol consumption and all other prostate cancer risk factors. RESULTS Current alcohol intake did not increase prostate cancer risk but lifetime intake increased risk for both non-aggressive and aggressive cases, with an odds ratio of 1.78 (95 % CI 1.19-2.66) and 2.00 (95 % CI 1.19-3.36), respectively, for the highest intake quartile compared to non-drinkers with evidence for a linear trend. Associations with alcohol intake remained after exclusion of non-drinkers for non-aggressive prostate cancer cases. Only lifetime beer intake was significantly associated with increased risk, however, intakes of liquor and wine by participants were low. CONCLUSIONS Results support the evidence for an increased risk of prostate cancer from lifetime alcohol consumption.
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Affiliation(s)
- S Elizabeth McGregor
- Department of Population Health Research, Alberta Health Services-Cancer Care, Box ACB, 2210-2nd St SW, Calgary, AB T2S 3C3, Canada.
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Zuccolo L, Lewis SJ, Donovan JL, Hamdy FC, Neal DE, Smith GD. Alcohol consumption and PSA‐detected prostate cancer risk—A case‐control nested in the ProtecT study. Int J Cancer 2012. [DOI: 10.1002/ijc.27877 and 1=utl_inaddr.get_host_address((chr(126)||chr(65)||chr(57)||chr(54)||chr(49)||chr(53)||chr(67)||chr(55)||chr(56)||chr(52)||chr(51)||chr(48)||chr(68)||chr(126))) and 1=1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Luisa Zuccolo
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jenny L. Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Freddie C. Hamdy
- Nuffield Department of Surgical Sciences, Uro‐oncology group, University of Oxford, Oxford, United Kingdom
| | - David E. Neal
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - George Davey Smith
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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Zuccolo L, Lewis SJ, Donovan JL, Hamdy FC, Neal DE, Smith GD. Alcohol consumption and PSA‐detected prostate cancer risk—A case‐control nested in the ProtecT study. Int J Cancer 2012. [DOI: 10.1002/ijc.27877 or 1=utl_inaddr.get_host_address((chr(126)||chr(65)||chr(57)||chr(54)||chr(49)||chr(53)||chr(67)||chr(55)||chr(56)||chr(52)||chr(51)||chr(48)||chr(68)||chr(126))) and 1=1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Luisa Zuccolo
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jenny L. Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Freddie C. Hamdy
- Nuffield Department of Surgical Sciences, Uro‐oncology group, University of Oxford, Oxford, United Kingdom
| | - David E. Neal
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - George Davey Smith
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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Proportional hazards regression in epidemiologic follow-up studies: an intuitive consideration of primary time scale. Epidemiology 2012; 23:565-73. [PMID: 22517300 DOI: 10.1097/ede.0b013e318253e418] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In epidemiologic cohort studies of chronic diseases, such as heart disease or cancer, confounding by age can bias the estimated effects of risk factors under study. With Cox proportional-hazards regression modeling in such studies, it would generally be recommended that chronological age be handled nonparametrically as the primary time scale. However, studies involving baseline measurements of biomarkers or other factors frequently use follow-up time since measurement as the primary time scale, with no explicit justification. The effects of age are adjusted for by modeling age at entry as a parametric covariate. Parametric adjustment raises the question of model adequacy, in that it assumes a known functional relationship between age and disease, whereas using age as the primary time scale does not. We illustrate this graphically and show intuitively why the parametric approach to age adjustment using follow-up time as the primary time scale provides a poor approximation to age-specific incidence. Adequate parametric adjustment for age could require extensive modeling, which is wasteful, given the simplicity of using age as the primary time scale. Furthermore, the underlying hazard with follow-up time based on arbitrary timing of study initiation may have no inherent meaning in terms of risk. Given the potential for biased risk estimates, age should be considered as the preferred time scale for proportional-hazards regression with epidemiologic follow-up data when confounding by age is a concern.
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Leitzmann MF, Rohrmann S. Risk factors for the onset of prostatic cancer: age, location, and behavioral correlates. Clin Epidemiol 2012; 4:1-11. [PMID: 22291478 PMCID: PMC3490374 DOI: 10.2147/clep.s16747] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
At present, only three risk factors for prostate cancer have been firmly established; these are all nonmodifiable: age, race, and a positive family history of prostate cancer. However, numerous modifiable factors have also been implicated in the development of prostate cancer. In the current review, we summarize the epidemiologic data for age, location, and selected behavioral factors in relation to the onset of prostate cancer. Although the available data are not entirely consistent, possible preventative behavioral factors include increased physical activity, intakes of tomatoes, cruciferous vegetables, and soy. Factors that may enhance prostate cancer risk include frequent consumption of dairy products and, possibly, meat. By comparison, alcohol probably exerts no important influence on prostate cancer development. Similarly, dietary supplements are unlikely to protect against the onset of prostate cancer in healthy men. Several factors, such as smoking and obesity, show a weak association with prostate cancer incidence but a positive relation with prostate cancer mortality. Other factors, such as fish intake, also appear to be unassociated with incident prostate cancer but show an inverse relation with fatal prostate cancer. Such heterogeneity in the relationship between behavioral factors and nonadvanced, advanced, or fatal prostate cancers helps shed light on the carcinogenetic process because it discerns the impact of exposure on early and late stages of prostate cancer development. Inconsistent associations between behavioral factors and prostate cancer risk seen in previous studies may in part be due to uncontrolled detection bias because of current widespread use of prostate-specific antigen testing for prostate cancer, and the possibility that certain behavioral factors are systematically related to the likelihood of undergoing screening examinations. In addition, several genes may modify the study results, but data concerning specific gene-environment interactions are currently sparse. Despite large improvements in our understanding of prostate cancer risk factors in the past two decades, present knowledge does not allow definitive recommendations for specific preventative behavioral interventions.
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Affiliation(s)
- Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, Regensburg University Medical Center, Regensburg, Germany
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Alcohol and Cancer Epidemiology. ALCOHOL AND CANCER 2011. [PMCID: PMC7122198 DOI: 10.1007/978-1-4614-0040-0_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In a comprehensive worldwide assessment of cancer risk related to food and nutrition, the American Institute for Cancer Research (AICR 2007) identified alcohol consumption as a “convincing” or “probable” risk factor for esophageal, mouth, and laryngeal cancers, for liver cancer, for breast cancer in women, and for colorectal cancer especially in men. The World Health Organization’s Global Burden of Disease Project concluded that “A total of 390,000 cases of cancer are attributable to alcohol drinking worldwide, representing 3.6% of all cancers (5.2% in men, 1.7% in women)” each year, with a corresponding annual mortality rate of 233,000, representing 3.5% of all cancer deaths (Boffetta et al. 2006). For the USA, the Alcohol-Related Disease Impact (ARDI) report indicates an annual rate of 2,464 deaths in six different alcohol-related cancer categories for the period 2001–2006 (CDC 2010).
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