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Risk factors for prostate cancer incidence and progression in the health professionals follow-up study.
Int J Cancer. 2007 Oct 01; 121(7):1571-8.IJ

Abstract

Risk factors for prostate cancer could differ for various sub-groups, such as for "aggressive" and "non-aggressive" cancers or by grade or stage. Determinants of mortality could differ from those for incidence. Using data from the Health Professionals Follow-Up Study, we re-examined 10 factors (cigarette smoking history, physical activity, BMI, family history of prostate cancer, race, height, total energy consumption, and intakes of calcium, tomato sauce and alpha-linolenic acid) using multivariable Cox regression in relation to multiple subcategories for prostate cancer risk. These were factors that we previously found to be predictors of prostate cancer incidence or advanced prostate cancer in this cohort, and that have some support in the literature. In this analysis, only 4 factors had a clear statistically significant association with overall incident prostate cancer: African-American race, positive family history, higher tomato sauce intake (inversely) and alpha-linolenic acid intake. In contrast, for fatal prostate cancer, recent smoking history, taller height, higher BMI, family history, and high intakes of total energy, calcium and alpha-linolenic acid were associated with a statistically significant increased risk. Higher vigorous physical activity level was associated with lower risk. In relation to these risk factors, advanced stage at diagnosis was a good surrogate for fatal prostate cancer, but high-grade (Gleason >/= 7 or Gleason >/= 8) was not. Only for high calcium intake was there a close correspondence for associations among high-grade cancer, advanced and fatal prostate cancer. Tomato sauce (inversely) and alpha-linolenic acid (positively) intakes were strong predictors of advanced cancer among those with low-grade cancers at diagnosis. Although the proportion of advanced stage cancers was much lower after PSA screening began, risk factors for advanced stage prostate cancers were similar in the pre-PSA and PSA era. The complexity of the clinical and pathologic manifestations of prostate cancer must be considered in the design and interpretation of studies.

Authors+Show Affiliations

Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA. edward.giovannucci@channing.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17450530

Citation

Giovannucci, Edward, et al. "Risk Factors for Prostate Cancer Incidence and Progression in the Health Professionals Follow-up Study." International Journal of Cancer, vol. 121, no. 7, 2007, pp. 1571-8.
Giovannucci E, Liu Y, Platz EA, et al. Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int J Cancer. 2007;121(7):1571-8.
Giovannucci, E., Liu, Y., Platz, E. A., Stampfer, M. J., & Willett, W. C. (2007). Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. International Journal of Cancer, 121(7), 1571-8.
Giovannucci E, et al. Risk Factors for Prostate Cancer Incidence and Progression in the Health Professionals Follow-up Study. Int J Cancer. 2007 Oct 1;121(7):1571-8. PubMed PMID: 17450530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. AU - Giovannucci,Edward, AU - Liu,Yan, AU - Platz,Elizabeth A, AU - Stampfer,Meir J, AU - Willett,Walter C, PY - 2007/4/24/pubmed PY - 2007/11/8/medline PY - 2007/4/24/entrez SP - 1571 EP - 8 JF - International journal of cancer JO - Int J Cancer VL - 121 IS - 7 N2 - Risk factors for prostate cancer could differ for various sub-groups, such as for "aggressive" and "non-aggressive" cancers or by grade or stage. Determinants of mortality could differ from those for incidence. Using data from the Health Professionals Follow-Up Study, we re-examined 10 factors (cigarette smoking history, physical activity, BMI, family history of prostate cancer, race, height, total energy consumption, and intakes of calcium, tomato sauce and alpha-linolenic acid) using multivariable Cox regression in relation to multiple subcategories for prostate cancer risk. These were factors that we previously found to be predictors of prostate cancer incidence or advanced prostate cancer in this cohort, and that have some support in the literature. In this analysis, only 4 factors had a clear statistically significant association with overall incident prostate cancer: African-American race, positive family history, higher tomato sauce intake (inversely) and alpha-linolenic acid intake. In contrast, for fatal prostate cancer, recent smoking history, taller height, higher BMI, family history, and high intakes of total energy, calcium and alpha-linolenic acid were associated with a statistically significant increased risk. Higher vigorous physical activity level was associated with lower risk. In relation to these risk factors, advanced stage at diagnosis was a good surrogate for fatal prostate cancer, but high-grade (Gleason >/= 7 or Gleason >/= 8) was not. Only for high calcium intake was there a close correspondence for associations among high-grade cancer, advanced and fatal prostate cancer. Tomato sauce (inversely) and alpha-linolenic acid (positively) intakes were strong predictors of advanced cancer among those with low-grade cancers at diagnosis. Although the proportion of advanced stage cancers was much lower after PSA screening began, risk factors for advanced stage prostate cancers were similar in the pre-PSA and PSA era. The complexity of the clinical and pathologic manifestations of prostate cancer must be considered in the design and interpretation of studies. SN - 0020-7136 UR - https://www.unboundmedicine.com/medline/citation/17450530/Risk_factors_for_prostate_cancer_incidence_and_progression_in_the_health_professionals_follow_up_study_ L2 - https://doi.org/10.1002/ijc.22788 DB - PRIME DP - Unbound Medicine ER -