Risk factors for the onset of prostatic cancer: age, location, and behavioral correlates.
Risk factors for the onset of prostatic cancer: age, location, and behavioral correlates.
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DOI：
10.2147/clep.s16747
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发表时间：
2012
影响因子：
3.9
通讯作者：
Rohrmann S
中科院分区：
文献类型：
--
作者：
Leitzmann MF;Rohrmann S
目前，只有三个前列腺癌的危险因素已经确定;这些都是不可改变的：年龄，种族和前列腺癌的阳性家族史。然而，许多可改变的因素也与前列腺癌的发展有关。在目前的综述中，我们总结了年龄、地点和选定的行为因素与前列腺癌发病相关的流行病学数据。虽然现有的数据并不完全一致，但可能的预防行为因素包括增加体育活动，摄入西红柿，十字花科蔬菜和大豆。可能增加前列腺癌风险的因素包括经常食用乳制品，可能还有肉类。相比之下，酒精可能对前列腺癌的发展没有重要影响。同样，膳食补充剂不太可能预防健康男性前列腺癌的发病。一些因素，如吸烟和肥胖，显示出与前列腺癌发病率的弱相关性，但与前列腺癌死亡率呈正相关。其他因素，如鱼类摄入量，似乎也与前列腺癌无关，但与致命的前列腺癌呈反比关系。行为因素与非晚期、晚期或致命性前列腺癌之间的这种异质性关系有助于阐明致癌过程，因为它识别了暴露对前列腺癌发展早期和晚期的影响。在以前的研究中发现的行为因素和前列腺癌风险之间的不一致的关联可能部分是由于不受控制的检测偏差，因为目前广泛使用的前列腺特异性抗原检测前列腺癌，以及某些行为因素的可能性是系统相关的可能性进行筛选检查。此外，一些基因可能会改变研究结果，但有关特定基因-环境相互作用的数据目前很少。尽管在过去的二十年里，我们对前列腺癌危险因素的理解有了很大的提高，但目前的知识并不允许对特定的预防性行为干预提出明确的建议。
At present, only three risk factors for prostate cancer have been firmly established; these are all nonmodifiable: age, race, and a positive family history of prostate cancer. However, numerous modifiable factors have also been implicated in the development of prostate cancer. In the current review, we summarize the epidemiologic data for age, location, and selected behavioral factors in relation to the onset of prostate cancer. Although the available data are not entirely consistent, possible preventative behavioral factors include increased physical activity, intakes of tomatoes, cruciferous vegetables, and soy. Factors that may enhance prostate cancer risk include frequent consumption of dairy products and, possibly, meat. By comparison, alcohol probably exerts no important influence on prostate cancer development. Similarly, dietary supplements are unlikely to protect against the onset of prostate cancer in healthy men. Several factors, such as smoking and obesity, show a weak association with prostate cancer incidence but a positive relation with prostate cancer mortality. Other factors, such as fish intake, also appear to be unassociated with incident prostate cancer but show an inverse relation with fatal prostate cancer. Such heterogeneity in the relationship between behavioral factors and nonadvanced, advanced, or fatal prostate cancers helps shed light on the carcinogenetic process because it discerns the impact of exposure on early and late stages of prostate cancer development. Inconsistent associations between behavioral factors and prostate cancer risk seen in previous studies may in part be due to uncontrolled detection bias because of current widespread use of prostate-specific antigen testing for prostate cancer, and the possibility that certain behavioral factors are systematically related to the likelihood of undergoing screening examinations. In addition, several genes may modify the study results, but data concerning specific gene–environment interactions are currently sparse. Despite large improvements in our understanding of prostate cancer risk factors in the past two decades, present knowledge does not allow definitive recommendations for specific preventative behavioral interventions.