1 Harvard T.H. Chan School of Public Health, Boston, MA.
2 Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
J Clin Oncol. 2019 Jun 10;37(17):1499-1511. doi: 10.1200/JCO.18.02462. Epub 2019 Apr 26.
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.
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.
Alcohol drinkers had a lower risk of lethal prostate cancer (any 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 none: HR, 0.99 [95% CI, 0.57 to 1.72]), whereas moderate red wine intake was associated with a lower risk (any none: HR, 0.50 [95% CI, 0.29 to 0.86]; 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 none: HR, 0.74 [95% CI, 0.57 to 0.97]; trend = .007).
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.
目前尚不清楚饮酒与致命（转移性或致死性）前列腺癌的风险是否相关。我们研究了（1）患有前列腺癌风险的男性的饮酒情况是否与致命性前列腺癌的诊断有关，以及（2）患有非转移性前列腺癌的男性的饮酒情况是否与转移或死亡有关。
本前瞻性队列研究使用了卫生专业人员随访研究（1986 年至 2012 年）。我们对有前列腺癌风险的男性的饮酒情况进行了分析，包括 47568 名无癌症的男性。我们对患有前列腺癌男性的饮酒情况的分析仅限于在随访期间被诊断为非转移性前列腺癌的 5182 名男性。我们研究了总酒精、红葡萄酒、啤酒和白酒与致命性前列腺癌和死亡的关系。多变量 Cox 比例风险回归估计了危险比（HRs）和 95%置信区间（CIs）。
饮酒者致命性前列腺癌的风险较低（任何酒：无饮酒者 HR，0.84[95%CI，0.71 至 0.99]），且与饮酒量无关。患有前列腺癌的患者的总酒精摄入量与进展为致命性前列腺癌无关（任何酒：无饮酒者 HR，0.99[95%CI，0.57 至 1.72]），而适量的红葡萄酒摄入与较低的风险相关（任何酒：无饮酒者 HR，0.50[95%CI，0.29 至 0.86]；趋势=0.05）。与无饮酒者相比，前列腺癌诊断后每天摄入 15 至 30 克的总酒精与死亡风险降低相关（HR，0.71[95%CI，0.50 至 1.00]），红葡萄酒也是如此（任何酒：无饮酒者 HR，0.74[95%CI，0.57 至 0.97]；趋势=0.007）。
与不饮酒者相比，无癌症的饮酒男性致命性前列腺癌的风险略低。在患有前列腺癌的男性中，红葡萄酒与进展为致命疾病的风险降低相关。这些观察到的关联值得进一步研究，但为患者提供了保证，即适量饮酒对患有前列腺癌的患者是安全的。
