TY - JOUR
T1 - Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States)
AU - Cerhan, James R.
AU - Torner, James C.
AU - Lynch, Charles F.
AU - Rubenstein, Linda M.
AU - Lemke, Jon H.
AU - Cohen, Michael B.
AU - Lubaroff, David M.
AU - Wallace, Robert B.
N1 - Funding Information:
Authors are with the University of Iowa College of Medicine, Iowa City, IA, USA. Drs Cerhan, Torner, Lynch, Rubenstein, Lemke, and Wallace are with the Department of Preventive Medicine and Environmental Health; Dr Cohen is with the Department of Pathology; Drs Cohen and Lubaroff are with the Department of Urology; Dr Wallace is with the Cancer Center. Address correspondence to Dr Cerhan, Department of Preventive Medicine and Environmental Health, 2800 Steindler Building, The University of Iowa College of Medicine, Iowa City, IA, 52242-1008, USA. This work was supported by grant R21 CA/ES69838 from the US National Cancer Institute. The Iowa 65+ Rural Health Study was supported by grants AG-O-2106, AG10127 and AG09682 from the US National Institute on Aging. Dr Cerhan was supported in part by a US National Cancer Institute Preventive Oncology Academic Award (K07 CA64220). Portions of this work were presented at the North American Association of Central Cancer Registries 1996 Annual Conference, Minneapolis, MN (USA), April 17-19, 1996.
PY - 1997
Y1 - 1997
N2 - 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 = 1.7 for BMI > 27.8 kg/m 2 compared with < 23.6; P trend = 0.1), and greater level of physical activity (RR = 1.9 for high activity level cf inactive; 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.
AB - 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 = 1.7 for BMI > 27.8 kg/m 2 compared with < 23.6; P trend = 0.1), and greater level of physical activity (RR = 1.9 for high activity level cf inactive; 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.
KW - United States
KW - men
KW - physical activity
KW - prostate neoplasms
KW - smoking
KW - weight
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U2 - 10.1023/A:1018428531619
DO - 10.1023/A:1018428531619
M3 - Article
C2 - 9134247
AN - SCOPUS:0030942049
SN - 0957-5243
VL - 8
SP - 229
EP - 238
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 2
ER -