吸烟与多种族队列中的前列腺癌。
Smoking and prostate cancer in a multi-ethnic cohort.
机构信息
Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
出版信息
Prostate. 2013 Oct;73(14):1518-28. doi: 10.1002/pros.22699. Epub 2013 Jul 3.
BACKGROUND
Prostate cancer (PCa) and smoking-related morbidity disproportionately burdens African American (AA) men. Smoking is associated with high-grade PCa and incidence, but few studies have focused on AA men. This study aims to determine the effect of tobacco-use on odds of PCa and of high-grade PCa in a population of predominantly AA men.
METHODS
This is a cross-sectional study evaluating smoking and PCa status in men with incident PCa and screened healthy controls. Altogether, 1,085 men (527 cases and 558 controls), age ≥ 40 years were enrolled through outpatient urology clinics in two US cities from 2001 to 2012. Validated questionnaires were used to gather clinical and socioeconomic data.
RESULTS
The cases and controls were predominantly AA (79.9% and 71.3%, respectively, P = 0.01). AA men smoked more frequently (53.4% vs. 47.9%, P < 0.001) and quit less frequently than European American (EA) men (31.5% vs. 40.4%, P = 0.01). AA heavy smokers had increased odds of PCa diagnosis (OR 2.57, 95% CI 1.09, 6.10) and high-grade cancer (OR 1.89, 95% CI 1.03, 3.48) relative to never smokers and light smokers. Among AAs, heavy smokers had lower odds of NCCN low PCa recurrence risk stratification. AA former smokers had a trend for increased odds of high-grade cancer compared to never smokers. The associations between smokings, cancer diagnosis and cancer grade did not reach statistical significance in EA men.
CONCLUSION
We found ethnic differences in smoking behavior. Heavy smoking is associated with increased odds of PCa and of higher Gleason grade in AA men.
背景
前列腺癌（PCa）和与吸烟相关的发病率不成比例地影响非裔美国人（AA）男性。吸烟与高级别 PCa 和发病率相关，但很少有研究关注 AA 男性。本研究旨在确定在主要为 AA 男性的人群中，吸烟与 PCa 以及高级别 PCa 的几率之间的关系。
方法
这是一项横断面研究，评估了 2001 年至 2012 年间，通过美国两个城市的门诊泌尿科诊所招募的患有 PCa 的男性（527 例病例和 558 例对照）和筛查健康对照者的吸烟状况和 PCa 状况。使用经过验证的问卷收集临床和社会经济数据。
结果
病例和对照组主要为 AA（分别为 79.9%和 71.3%，P=0.01）。AA 男性吸烟更频繁（53.4%比 47.9%，P<0.001），戒烟频率低于欧洲裔美国男性（31.5%比 40.4%，P=0.01）。与从不吸烟者和轻度吸烟者相比，AA 重度吸烟者诊断为 PCa 的几率增加（OR 2.57，95%CI 1.09，6.10）和高级别癌症（OR 1.89，95%CI 1.03，3.48）。在 AA 人群中，重度吸烟者的 NCCN 低 PCa 复发风险分层几率较低。与从不吸烟者相比，AA 前吸烟者的高级别癌症风险呈上升趋势。在 EA 男性中，吸烟、癌症诊断和癌症分级之间的关联没有达到统计学意义。
结论
我们发现了吸烟行为方面的种族差异。重度吸烟与 AA 男性 PCa 和高级别 Gleason 分级的几率增加有关。
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