Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States)
Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States)
复制标题
DOI：
10.1023/a:1018428531619
复制
发表时间：
1997-03-01
影响因子：
2.3
通讯作者：
Wallace, RB
中科院分区：
文献类型：
--
作者：
Cerhan, JR;Torner, JC;Wallace, RB
吸烟、肥胖、酒精和体力活动可以调节内分泌系统，因此被假设在前列腺癌的病因学中起作用。在1982年的基线，爱荷华州（美国）两个农村县的80%（n = 3,673）年龄在65岁以上的非住院人员参加了爱荷华州65岁以上农村健康研究。死亡率随访至1993年，癌症经历通过与1973-93年爱荷华州国家卫生登记处癌症数据库的联系来确定。我们分析了1,050名年龄在65岁到101岁之间（平均年龄73.5岁）的男性的数据，他们在1982年进行了全面的访谈，在基线前的10年里没有记录到癌症。到1993年（8,474人年的随访），有71例前列腺癌的发病病例。在多变量模型中，年龄，吸烟（与从不吸烟相比，目前每天吸烟20支或更多的相对风险[RR] = 2.9; P趋势= 0.009），更大的体重指数（BMI）（wt/ht（2））（RR = 2与< 23.6相比; P趋势= 0.1），以及更高的体力活动水平BMI > 27.8kg/m2时RR = 1.9，RR = 1.7; P趋势= 0.05）是前列腺癌的独立预测因子，并且这些关联对于诊断时的区域性或播散性疾病更强。BMI从50岁到基线的百分比变化与风险呈正相关（P趋势= 0.01），并且这种关联在较重的男性中似乎更强。没有关于饮食的数据。这些研究结果表明，吸烟，超重和体重增加是前列腺癌的危险因素，并支持激素病因;体力活动的积极关联证实了一些以前的报告，但仍然没有可信的生物学机制。
Smoking, obesity, alcohol, and physical activity can modulate the endocrine system, and therefore have been hypothesized to play a role in the etiology of prostate cancer. At baseline in 1982, 80 percent (n = 3,673) of the noninstitutionalized persons age 65+ in two rural Iowa (United States) counties were enrolled into the Iowa 65+ Rural Health Study. Follow-up for mortality was complete through 1993, and cancer experience was determined by linkage to the State Health Registry of Iowa cancer database for the years 1973-93. We analyzed data on 1,050 men aged 65 to 101 years (mean age 73.5) with a full interview in 1982 and with no documented cancer in the 10 years prior to baseline, Through 1993 (8,474 person-years of follow-up), there were 71 incident cases of prostate cancer. In a multivariate model, age, cigarette smoking (relative risk [RR] = 2.9 for currently smoking 20 or more cigarettes per day compared with never smoking; P trend = 0.009), greater body mass index (BMI) (wt/ht(2)) (RR = 2 compared with < 23.6; P trend = 0.1), and greater level of physical activity (RR = 1.9 for 1.7 for BMI > 27.8 kg/m(2) high activity level cfinactive; P trend = 0.05) were independent predictors of prostate cancer, and these associations were stronger for regional or disseminated disease at diagnosis. Percent change in BMI from age 50 to baseline was associated positively with risk (P trend = 0.01), and this association appeared to be stronger in heavier men. There were no data on diet. These findings suggest that smoking, overweight, and weight gain in later life are risk factors for prostate cancer and support a hormonal etiology; the positive association for physical activity confirms some previous reports, but remains without a credible biologic mechanism.