MODIFIABLE RISK FACTORS FOR PROSTATE CANCER

除了非黑色素瘤皮肤癌，前列腺癌是当今美国男性中最常见的癌症。尽管它很重要，但这种疾病的可改变的预测因素很少。前列腺癌的既定危险因素，如年龄、家族史、种族和居住国是无法改变的，因此，作为初级预防策略目标的效用有限。已经提出了几个可改变的特征来预测前列腺癌的风险。这些因素包括身体活动、各种人体测量、吸烟、饮酒和饮食。然而，关于这些关联的数据并不一致。为了提供更多的信息，我们建议利用已有的数据分析这些特征与前列腺癌风险的关系。1988年，11122名平均年龄为68岁、无癌症的男性提交了一份健康问卷。男性提供了广泛的信息，包括体力活动、体重、身高、腰围、吸烟、饮酒、饮食和维生素补充剂的数据。在1988年以前长达26年的时间里，也曾在1962年或1966年和1977年的调查表上对这些特征进行了反复评估。此外，男子在年满18岁时接受了标准化的体检。在1988年到1993年的随访中，495例前列腺癌发生。这个庞大的数据库提供了一个独特的机会，以相对较少的成本，澄清各种可改变的特征与前列腺癌风险的关系。由于可以进行重复评估，因此可以检查与风险有关的变化和连续性。这些分析的结果，特别是关于变化的结果，将具有公共卫生意义。

Apart from non-melanoma skin cancer, prostate cancer is the most commonly diagnosed cancer among men in the United States today. In spite of its importance, few modifiable predictors of this disease have been established. Well-established risk factors for prostate cancer, such as age, family history, race, and country of residence are not amenable to modification and, hence, have limited utility as targets of primary prevention strategies. Several modifiable characteristics have been proposed to predict risk of prostate cancer. These include physical activity, various anthropometric measures, cigarette smoking, alcohol consumption, and diet. However, data regarding these associations have been inconsistent. To provide more information, we propose to analyze the associations of these characteristics with prostate cancer risk using data that already are available. In 1988, 11,122 men, with mean age 68 years and who were free of cancer, returned a health questionnaire. Men provided a wide range of information, including data on physical activity, weight, height, waist girth, smoking, alcohol intake, diet, and vitamin supplements. Repeated assessments of these characteristics also have been made over a span of up to 26 years prior to 1988, on questionnaires in 1962 or 1966 and 1977. In addition, men had undergone a standardized medical examination when they were aged 18 years. During follow-up from 1988 through 1993, 495 cases of prostate cancer developed. This large database provides a unique opportunity, at relatively little cost, to clarify the associations of various modifiable characteristics with prostate cancer risk. Because repeated assessments are available, changes and continuities can be examined in relation to risk. Findings from these analyses, especially with regard to changes, will have public health significance.