Ziglioli Francesco, Patera Annalisa, Isgrò Gianmarco, Campobasso Davide, Guarino Giulio, Maestroni Umberto
Department of Urology, University Hospital of Parma, Parma, Italy.
Department of Urology, James Cook University Hospital, Middlesbrough, United Kingdom.
Front Oncol. 2023 Sep 8;13:1203791. doi: 10.3389/fonc.2023.1203791. eCollection 2023.
Although prostate cancer (PCa) is one of the most common cancers among men, the impact of modifiable risk and protective factors is still being debated. This review aims to qualitatively summarize the most recent studies related to potential healthy lifestyle factors affecting the development of PCa.
The literature focusing on modifiable risk factors for prostate cancer was reviewed. Medline and Embase via the Ovid database were searched, and all relevant and inherent articles were analyzed. Non-eligible publications, such as review articles, editorials, comments, guidelines, or case reports, were excluded.
This review confirms that there is strong evidence that being overweight or obese increases the risk of advanced prostate cancer (assessed by body mass index (BMI), waist circumference, and waist-hip ratio), particularly considering central adiposity and ethnicity as contributing factors. The possible contribution of smoking still seems not entirely clear, while alcohol seems to affect PCa prevention in patients taking 5α-reductase inhibitors (5-ARIs). Dietary fibers may have anti-inflammatory properties and improve insulin sensitivity by reducing IGF bioactivity. In particular, dietary fiber intake like insoluble and legume fibers may be inversely associated with prostate cancer risk. Also, hyperglycemia and hyperinsulinemia, with untreated diabetic fasting blood glucose levels, could be modifiable prostate cancer risk factors. In two studies, aspirin was associated with a lower risk of lethal PCa and overall mortality. Concerning the role of vitamins, despite conflicting and divergent results, serum retinol concentration seems to be associated with an increased risk of prostate cancer and high-grade prostate cancer. Some studies resulted in disagreement about the role of selenium and vitamin E. We found inconsistent and controversial findings about the association between vitamin D and prostate cancer risk.
Far from being conclusive evidence, our findings confirm some strong evidence already found in the previous literature and highlight the need to clarify the role of some risk factors whose role is not yet completely known. This effort would facilitate the cultural and social change that may allow the shift from the treatment of prostate cancer when diagnosed to the real efforts needed for systematic prevention.
尽管前列腺癌是男性中最常见的癌症之一，但可改变的风险因素和保护因素的影响仍存在争议。本综述旨在定性总结与影响前列腺癌发生的潜在健康生活方式因素相关的最新研究。
对聚焦于前列腺癌可改变风险因素的文献进行综述。通过Ovid数据库检索Medline和Embase，并分析所有相关及内在的文章。排除不符合条件的出版物，如综述文章、社论、评论、指南或病例报告。
本综述证实，有强有力的证据表明超重或肥胖会增加晚期前列腺癌的风险（通过体重指数（BMI）、腰围和腰臀比评估），尤其考虑到中心性肥胖和种族是促成因素。吸烟的可能影响似乎仍不完全明确，而酒精似乎对服用5α-还原酶抑制剂（5-ARIs）的患者的前列腺癌预防有影响。膳食纤维可能具有抗炎特性，并通过降低胰岛素样生长因子（IGF）生物活性来改善胰岛素敏感性。特别是，不溶性纤维和豆类纤维等膳食纤维摄入量可能与前列腺癌风险呈负相关。此外，高血糖和高胰岛素血症，以及未经治疗的糖尿病空腹血糖水平，可能是可改变的前列腺癌风险因素。在两项研究中，阿司匹林与致命性前列腺癌风险降低及总体死亡率降低相关。关于维生素的作用，尽管结果相互矛盾且不一致，但血清视黄醇浓度似乎与前列腺癌和高级别前列腺癌风险增加相关。一些研究对硒和维生素E的作用存在分歧。我们发现关于维生素D与前列腺癌风险之间的关联存在不一致且有争议的结果。
我们的研究结果远非确凿证据，而是证实了先前文献中已发现的一些强有力的证据，并强调需要阐明一些作用尚未完全明确的风险因素的作用。这项工作将促进文化和社会变革，从而有可能实现从前列腺癌确诊时的治疗向系统预防所需的实际努力的转变。
