Park Song-Yi, Haiman Christopher A, Cheng Iona, Park Sungshim Lani, Wilkens Lynne R, Kolonel Laurence N, Le Marchand Loïc, Henderson Brian E
Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
Cancer Causes Control. 2015 Oct;26(10):1507-15. doi: 10.1007/s10552-015-0644-y. Epub 2015 Aug 5.
Older age, African ancestry, and family history of prostate cancer are well-established risk factors for prostate cancer, and all are non-modifiable. Various lifestyle factors have been examined in relation to prostate cancer risk, including diet, obesity, and physical activity; however, none of them has been consistently related to risk. In the Multiethnic Cohort Study, we investigated whether lifestyle-related factors are associated with prostate cancer risk and whether such factors explain the racial/ethnic differences in risk.
During a mean follow-up of 13.9 years, 7,115 incident cases were identified among 75,216 white, African-American, Native Hawaiian, Japanese American, and Latino men. Cox proportional hazards models were used to calculate relative risks (RRs) and 95 % confidence intervals (95 % CIs) for prostate cancer.
Among selected lifestyle-related factors including body mass index, height, education, physical activity, and intakes of alcohol, calcium, legumes, lycopene, and selenium, only smoking (RR for current (≥20 cigarettes/day) vs. never smoking = 0.72; 95 % CI 0.63-0.83) and history of diabetes (RR for yes vs. no = 0.78; 95 % CI 0.72-0.85) were significantly associated with prostate cancer risk. Compared to whites, the risk of incident prostate cancer was twofold higher in African-Americans and 16 % higher in Latinos. Additional adjustment for a history of PSA testing did not change the results.
The findings suggest that racial/ethnic differences in prostate cancer risk are not explained by the lifestyle factors examined and that underlying genetic factors may be involved.
老年、非洲裔血统以及前列腺癌家族史是公认的前列腺癌风险因素，且均不可改变。已对多种生活方式因素与前列腺癌风险的关系进行了研究，包括饮食、肥胖和身体活动；然而，这些因素均未始终如一地与风险相关。在多民族队列研究中，我们调查了与生活方式相关的因素是否与前列腺癌风险相关，以及这些因素是否能解释风险的种族/民族差异。
在平均13.9年的随访期间，在75216名白人、非裔美国人、夏威夷原住民、日裔美国人和拉丁裔男性中确定了7115例新发病例。使用Cox比例风险模型计算前列腺癌的相对风险（RRs）和95%置信区间（95% CIs）。
在选定的与生活方式相关的因素中，包括体重指数、身高、教育程度、身体活动以及酒精、钙、豆类、番茄红素和硒的摄入量，只有吸烟（当前吸烟者（≥20支/天）与从不吸烟者相比的RR = 0.72；95% CI 0.63 - 0.83）和糖尿病史（有糖尿病史与无糖尿病史相比的RR = 0.78；95% CI 0.72 - 0.85）与前列腺癌风险显著相关。与白人相比，非裔美国人患前列腺癌的风险高出两倍，拉丁裔高出16%。对前列腺特异性抗原（PSA）检测史进行额外调整并未改变结果。
研究结果表明，所研究的生活方式因素并不能解释前列腺癌风险的种族/民族差异，可能涉及潜在的遗传因素。
