Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, US.
Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, US.
Br J Cancer. 2023 Oct;129(6):974-981. doi: 10.1038/s41416-023-02364-1. Epub 2023 Jul 24.
Previous studies investigating relationship between atopic allergic conditions (AACs)-a highly reactive immune state-and prostate cancer (PCa) risk were inconclusive, and few have studied diverse racial/ethnic populations.
We analysed 74,714 men aged ≥45 years at enrollment in Multiethnic Cohort study. Using multivariable Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for self-reported AAC status on PCa outcomes.
Through 2017, 8697 incident PCa and 1170 related deaths occurred. Twenty-one percent of men reported a history of AACs. AACs were not associated with incident PCa (HR = 0.98, 95% CI: 0.93-1.03) but were significantly inversely associated with PCa mortality (HR = 0.79, 95% CI: 0.67-0.92). This inverse association was consistently observed across all racial/ethnic groups (HR range: 0.60-0.90). Among men diagnosed with PCa, AACs were inversely associated with PCa-specific death (HR = 0.75, 95% CI: 0.63-0.89). Adjusting for potential confounding effect of PSA screening did not meaningfully change the results. No significant heterogeneity was observed in the effect of AACs on PCa incidence or mortality by Dietary Inflammatory Index.
Hyper-allergic conditions were not associated with PCa incidence but were inversely associated with PCa mortality, suggesting a potential role in reducing tumour progression. Further aetiological research is warranted to understand underlying mechanisms.
既往研究调查特应性过敏状态（一种高度反应性免疫状态）与前列腺癌（PCa）风险之间的关系尚无定论，且很少有研究涉及不同种族/民族人群。
我们分析了多民族队列研究中 74714 名年龄≥45 岁的男性。使用多变量 Cox 回归，我们估计了自述特应性过敏状态与 PCa 结局的风险比（HR）和 95%置信区间（CI）。
截至 2017 年，发生了 8697 例 PCa 和 1170 例相关死亡。21%的男性报告有特应性过敏史。特应性过敏与 PCa 发病无关（HR=0.98，95%CI：0.93-1.03），但与 PCa 死亡率显著负相关（HR=0.79，95%CI：0.67-0.92）。这种负相关在所有种族/民族群体中均一致观察到（HR 范围：0.60-0.90）。在被诊断为 PCa 的男性中，特应性过敏与 PCa 特异性死亡呈负相关（HR=0.75，95%CI：0.63-0.89）。调整 PSA 筛查的潜在混杂效应并未显著改变结果。在特应性过敏对 PCa 发病率或死亡率的影响方面，饮食炎症指数没有显著的异质性。
高过敏状态与 PCa 发病无关，但与 PCa 死亡率负相关，提示其在降低肿瘤进展方面可能发挥作用。需要进一步进行病因学研究以了解潜在机制。
