Risk factors for prostate cancer: A national case‐control study

Abstract

Statutory notification of cancer in New Zealand provided an opportunity to investigate risk factors for prostate cancer in a large national population-based case-control study. We analyzed data obtained from telephone interviews with 923 cases and 1,224 controls. For inclusion in the study, all subjects had to have been married at some time. We found an increased risk of prostate cancer among those with a history of prostate cancer in first degree relatives (RR 2.6; 95% CI, 1.9-3.7) and an increased risk of prostate cancer with length of marriage among men married only once and still married at interview. For a consecutive subgroup of 550 cases and 819 controls, data on height and weight at age 20 and at 5 years before interview were collected. Men less than or equal to 1.7 m in height at age 20 years had a lower risk of prostate cancer than men taller at that age. There was no association between weight or body mass index and risk of prostate cancer. ' 2006 Wiley-Liss, Inc.Key words: prostate cancer; height; marriage; risk factors; casecontrol study Important epidemiological features of prostate cancer remain poorly understood. In particular, the rapidly increasing risk of prostate cancer with advancing age, trends in prostate cancer incidence and mortality, and ethnic differences with low rates in Asian populations and high rates in American blacks are not easily explained.1 Many risk factors for prostate cancer have been proposed but, apart from age and a strong family history of the disease, the associations are relatively weak. Although genetic effects on risk have been proposed, the 60-fold variation in prostate cancer incidence among countries is not likely to be wholly due to genetic determinants and strongly suggests the importance of environmental factors. 1The roles of obesity, height, weight, body mass index, and lean body mass have been assessed, and the results provide limited evidence of any effect on risk of prostate cancer.2 Any such alteration in risk may be restricted to more advanced, progressive or fatal disease. 3 The finding of a possible increased risk with increasing adult height has led to recent investigations of potential hormonal factors during puberty, and particularly the growth spurt during puberty, as risk factors for prostate cancer in later life. 4 An increased risk of prostate cancer from diets high in total energy, possibly from relatively high consumption of animal fat, has been suggested, but results have been inconsistent.2 Weak protective effects from the consumption of carotenoids, vitamins C and E, some vegetables and the level of vitamin D have been suggested, but there are major methodological difficulties in assessing dietary exposures. 5,6 A small randomized controlled trial of selenium supplementation for the prevention of skin cancer found a lower incidence of prostate cancer in those taking selenium, 7 but observational studies have not consistently found an increased risk of prostate cancer with low selenium intake. 8 Reduced physical activity has also been sug...

A Prospective Investigation of Height and Prostate Cancer Risk

“…Associations between height and clinically relevant prostate cancer have been examined (16,21,24,(29)(30)(31)(33)(34)(35), with stronger associations observed for more advanced versus localized disease in several studies (24,(29)(30)(31), which is in accord with the present findings. For example, a particularly strong association between tallness and aggressive prostate cancer was noted in the Auckland Prostate Study for men taller than 179 cm who also had a positive family history of prostate cancer, although stratum-specific sample sizes were small (HR, 7.41; 95% CI, 1.68-32.67; P trend = 0.02; ref.…”

“…Case-control studies have reported predominantly weak or no associations (4,10,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), whereas several cohort studies found statistically significant elevations in risk (27)(28)(29)(30)(31)(32)(33). Eight studies have specifically evaluated height as a risk factor for clinically advanced cancer (16,21,24,(29)(30)(31)(33)(34)(35), with three reporting >50% increases in risk of advanced disease for men taller than 173 cm (24,29,30). Because the associations between height and prostate cancer seemed to be relatively modest in the aforementioned studies, large numbers of cases are required to detect small yet meaningful associations.…”

The association between leukocyte telomere length and cigarette smoking, dietary and physical variables, and risk of prostate cancer

“…In general, these cancers have diverse underlying carcinogenic pathways. Smoking is a strong risk factor in bladder, lung, and head and neck cancer whereas it does not appear to be a significant prostate cancer risk factor, either in the present study or in many others (US Department of Health and Human Services, 2004; Cox et al. , 2006; Darlington et al.…”

Height and risk of prostate cancer in the prostate, lung, colorectal, and ovarian cancer screening trial

“…More than 30 prospective and 27 case -control studies have examined height and overall prostate cancer risk (Macinnis and English, 2006;Zuccolo et al, 2008), but findings are mixed; some studies showed a positive association (Le Marchand et al, 1994;Andersson et al, 1997;Giovannucci et al, 1997;Hebert et al, 1997;Rodriguez et al, 2001;Engeland et al, 2003;Cox et al, 2006;Sequoia et al, 2006;Zuccolo et al, 2008), whereas others found no relation (Severson et al, 1988;Cerhan et al, 1997;Veierod et al, 1997;Nilsen and Vatten, 1999;Clarke and Whittemore, 2000;Pischon et al, 2008). Stronger associations were observed for more advanced or fatal prostate cancer among 7 (Andersson et al, 1997;Giovannucci et al, 1997Giovannucci et al, , 2004Rodriguez et al, 2001;Cox et al, 2006;Sequoia et al, 2006;Zuccolo et al, 2008) of the 14 (Le Marchand et al, 1994;Andersson et al, 1997;Giovannucci et al, 1997Giovannucci et al, , 2004Nilsen and Vatten, 1999;Habel et al, 2000;Hsing et al, 2000;Norrish et al, 2000;Rodriguez et al, 2001;Macinnis et al, 2003;Cox et al, 2006;Sequoia et al, 2006;Pischon et al, 2008;Zuccolo et al, 2008) studies ...…”