Diet and Lifestyle in Prostate Cancer
Diet and Lifestyle in Prostate Cancer
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DOI：
10.1007/978-3-030-32656-2_1
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发表时间：
2019-01-01
期刊：
影响因子：
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通讯作者：
Mucci, Lorelei A.
中科院分区：
文献类型：
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作者：
Wilson, Kathryn M.;Mucci, Lorelei A.
在大型前瞻性队列研究中，人们研究了各种饮食和生活方式因素与前列腺癌风险的关系。尽管如此，与其他常见癌症相比，很少有可改变的风险因素被确定为在前列腺癌中发挥作用。对于缺乏确定的风险因素，有几种可能的解释。首先，前列腺癌是所有常见癌症中遗传率最高的癌症之一;其次，在大多数流行病学研究中，早期生活暴露可能在风险中发挥重要作用，而不是中期和晚期生活暴露。最后，前列腺特异性抗原（PSA）筛查在前列腺癌的检测和发病率中起着至关重要的作用，这对流行病学研究具有重要意义。在可改变的风险因素中，吸烟和肥胖一直与晚期前列腺癌的高风险相关。还有相当多的证据表明，乳制品摄入量与总体前列腺癌风险之间存在正相关，而煮熟的番茄/番茄红素摄入量与晚期疾病风险之间存在负相关。在观察性研究中，包括硒和维生素E在内的其他几个饮食因素一直与风险相关，但临床试验的结果却令人怀疑。其他经过充分研究的饮食因素，包括脂肪摄入量，红肉，鱼，维生素D，大豆和植物雌激素的结果是混合的。实际上，应该鼓励关注前列腺癌风险的男性戒烟，尽可能多地锻炼身体，达到或保持健康的体重。这些建议也具有对2型糖尿病，心血管疾病和其他慢性疾病的风险产生积极影响的优势。减少乳制品的摄入量，同时增加鱼类和番茄制品的消费也是合理的建议。
A variety of diet and lifestyle factors have been studied with respect to prostate cancer risk in large, prospective cohort studies. In spite of this work, and in contrast to other common cancers, few modifiable risk factors have been firmly established as playing a role in prostate cancer. There are several possible explanations for the lack of well-established risk factors. First, prostate cancer has among the highest heritability of all common cancers; second, early life exposures may play an important role in risk, rather than mid- and later-life exposures assessed in most epidemiological studies. Finally, prostate-specific antigen (PSA) screening plays a critical role in prostate cancer detection and incidence rates, which has important implications for epidemiological studies.Among modifiable risk factors, smoking and obesity are consistently associated with higher risk specifically of advanced prostate cancer. There is also considerable evidence for a positive association between dairy intake and overall prostate cancer risk, and an inverse association between cooked tomato/lycopene intake and risk of advanced disease. Several other dietary factors consistently associated with risk in observational studies, including selenium and vitamin E, have been cast into doubt by results from clinical trials. Results for other well-studied dietary factors, including fat intake, red meat, fish, vitamin D, soy and phytoestrogens are mixed.In practical terms, men concerned with prostate cancer risk should be encouraged to stop smoking, be as physically active as possible, and achieve or maintain a healthy weight. These recommendations also have the advantage of having a positive impact on risk of type 2 diabetes, cardiovascular disease, and other chronic diseases. Reducing dairy intake while increasing consumption of fish and tomato products is also reasonable advice.