Putnam S D, Cerhan J R, Parker A S, Bianchi G D, Wallace R B, Cantor K P, Lynch C F
Department of Preventive Medicine and Environment Health, University of Iowa, College of Medicine, Iowa City, IA, USA.
Ann Epidemiol. 2000 Aug;10(6):361-9. doi: 10.1016/s1047-2797(00)00057-0.
Several lines of evidence suggest that prostate cancer has a hormonal etiology. We evaluated factors known to modulate the endocrine system, including alcohol and tobacco use, physical activity, and obesity as risk factors for prostate cancer.
Cancer-free controls who participated in a population-based case-control study from 1986-1989 (81% response rate) were followed through 1995 for cancer incidence by linkage to the Iowa Cancer Registry; 101 incident prostate cancers were identified.
Compared with non-users of alcohol, men who consumed <22 grams alcohol per week (relative risk [RR] = 1.1; 95% Confidence Interval [CI] 0.6-2.1), 22-96 grams alcohol per week (RR = 2.6; 95% CI 1.4-4. 6) and >96 grams alcohol per week (RR = 3.1; 95% CI 1.5-6.3) were at increased risk of prostate cancer after adjustment for age, family history of prostate cancer, body mass index, total energy, and intake of carbohydrate, linoleic acid, lycopene, retinol, and red meat (p for trend < 0.0001). The respective RRs were similar when assessing type of alcohol consumed (beer, wine or liquor) or when well-differentiated, localized tumors were excluded. Body mass index was only weakly and positively associated with prostate cancer after adjustment for age, but this association strengthened after multivariate adjustment and exclusion of well-differentiated, localized tumors. For the latter tumors, men with a BMI of 24.1-26.6 kg/m(2) and >26.6 kg/m(2) were at elevated risk compared to men with a BMI <24.1 kg/m(2). Tobacco use (cigarettes, cigar/pipe, chewing tobacco and snuff use), height, weight, and both leisure and occupational physical activity were not associated with risk of prostate cancer in this cohort.
These data suggest that in white men obesity is a risk factor for more clinically significant prostate cancer and confirm limited previous reports showing that alcohol consumption is positively associated with prostate cancer and that this risk is not limited to any specific type of alcohol.
多项证据表明前列腺癌具有激素病因。我们评估了已知可调节内分泌系统的因素，包括饮酒和吸烟、身体活动以及肥胖作为前列腺癌的风险因素。
参与了1986 - 1989年一项基于人群的病例对照研究（应答率81%）的无癌对照者，通过与爱荷华癌症登记处联动，随访至1995年以确定癌症发病率；共识别出101例新发前列腺癌病例。
与不饮酒者相比，每周饮酒量<22克的男性（相对风险[RR]=1.1；95%置信区间[CI]0.6 - 2.1）、每周饮酒量22 - 96克的男性（RR = 2.6；95% CI 1.4 - 4.6）以及每周饮酒量>96克的男性（RR = 3.1；95% CI 1.5 - 6.3），在调整年龄、前列腺癌家族史、体重指数、总能量以及碳水化合物、亚油酸、番茄红素、视黄醇和红肉摄入量后，患前列腺癌的风险增加（趋势p<0.0001）。在评估所饮用酒精类型（啤酒、葡萄酒或烈酒）时，或排除高分化、局限性肿瘤时，各自的RR相似。调整年龄后，体重指数与前列腺癌仅呈微弱的正相关，但在多变量调整并排除高分化、局限性肿瘤后，这种关联增强。对于后一种肿瘤，体重指数为24.1 - 26.6 kg/m²和>26.6 kg/m²的男性与体重指数<24.1 kg/m²的男性相比，风险升高。在该队列中，吸烟（香烟、雪茄/烟斗、嚼烟和鼻烟）、身高、体重以及休闲和职业身体活动与前列腺癌风险无关。
这些数据表明，在白人男性中，肥胖是更具临床意义的前列腺癌的风险因素，并证实了先前有限的报告，即饮酒与前列腺癌呈正相关，且这种风险不限于任何特定类型的酒精。
