A Critical Assessment of Epidemiology Studies Regarding Dietary/Supplemental Zinc and Prostate Cancer Risk.
A Critical Assessment of Epidemiology Studies Regarding Dietary/Supplemental Zinc and Prostate Cancer Risk.
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DOI：
10.2174/1874303x00801010026
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发表时间：
2008-01-01
期刊：
影响因子：
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通讯作者：
Tan, Ming T
中科院分区：
文献类型：
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作者：
Costello, Leslie C;Franklin, Renty B;Tan, Ming T
尽管前列腺癌的患病率很高，但与其发展和进展相关的病因和因素在很大程度上是未知的。前列腺癌的一个重要关系是锌的作用。临床证据和实验证据已经证实，前列腺癌与恶性细胞中锌摄取和积累的减少有关;并且前列腺细胞中锌的积累防止恶性肿瘤。与此形成对比的是，大量关于饮食和补充锌对前列腺癌发病率影响的流行病学研究和报告提供了不同的、不一致的和不确定的结果;其范围从锌的不良作用、锌的保护作用到锌对前列腺癌风险没有影响。尽管有这些不同的和不确定的结果，一个流行的观点和公共警告已经从未经证实和未经证实的流行病学研究中演变出来，即锌的摄入会增加患晚期前列腺癌的风险。这样的结论是没有根据的，对医学/科学界和广大公众有严重、混乱和错误的影响。Dimitrios Trichopoulos在十多年前的警告[1]，“（流行病学）研究将不可避免地以令人不安的频率产生假阳性和假阴性结果。当（人们）认真对待我们时，我们可能无意中弊大于利"可以适用于本报告所述的情况。因此，审查导致锌不良作用结论的流行病学研究以及产生不一致和不同结果的研究是非常重要的。这一重要的审查定义的问题，存在的问题和缺点，在进行，结论和传播的流行病学研究。我们提醒，在评估饮食和补充锌对前列腺癌风险的相关性的流行病学研究结果的有效性和结论性时，应该了解和理解这些问题;特别是当未经证实的结论与临床和实验证据不一致时。进行这一严格的审查是为了医学、科学和公众的利益。我们希望，这次审查将促成对这一重要问题进行公开、客观、科学和医学的讨论和评估。
Despite the prevalence of prostate cancer, the etiology and factors associated with its development and progression are largely unknown. An important relationship in prostate cancer is the role of zinc. Clinical evidence and experimental evidence have established that prostate cancer is associated with a decrease in the zinc uptake and accumulation in the malignant cells; and that the accumulation of zinc in the prostate cells prevents malignancy. In contrast to this established consistent clinical relationship, numerous epidemiology studies and reports of the effect of dietary and supplemental zinc on the incidence of prostate cancer have provided divergent, inconsistent, and inconclusive results; which range from adverse effects of zinc, protective effects of zinc, and no effect of zinc on the risk of prostate cancer. Despite these divergent and inconclusive results, a prevailing view and public warning has evolved from unsubstantiated and uncorroborated epidemiology studies that zinc consumption increases the risk of developing advanced stage prostate cancer. Such a conclusion is not well-founded and has serious, confusing and erroneous implications for the medical/scientific community and for the public-at-large. The admonition of Dimitrios Trichopoulos over a decade ago [1] that, " (epidemiology) studies will inevitably generate false positive and false negative results with disturbing frequency. , when (people) do take us seriously, we may unintentionally do more harm than good" can be applied to the situation that is the subject of this report. Therefore it is extremely important to review the epidemiology studies that have lead to the conclusion of an adverse effect of zinc, and also that have produced such inconsistent and divergent results. This critical review defines issues, problems, and shortcomings that exist in the conduct, conclusions, and dissemination of the epidemiology studies. We caution that one should be knowledgeable and understanding of these issues in assessing the validity and the conclusiveness of the outcomes from the epidemiology studies of purported associations of dietary and supplemental zinc on the risk of prostate cancer; particularly when the unsubstantiated conclusions are at odds with clinical and experimental evidence. It is in the interest of the medical, scientific and public communities that this critical review is undertaken. We hope that this review will generate an open, objective, scientific and medical discussion and assessment of this important issue.