Journal
BRITISH JOURNAL OF CANCER
Volume 108, Issue 3, Pages 708-714Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bjc.2012.520
Keywords
smoking; prostate cancer; cohort study; EPIC
Categories
Funding
- European Commission Public Health and Consumer Protection Directorate
- Research Directorate-General
- Deutsche Krebshilfe (German Cancer Aid)
- Deutsches Krebsforschungszentrum (German Cancer Research Centre)
- German Federal Ministry of Education and Research
- Danish Cancer Society
- Health Research Fund (FIS) of the Spanish Ministry of Health
- Spanish Regional Government of Andalucia
- Spanish Regional Government Asturia
- Spanish Regional Government Basque Country
- Spanish Regional Government Murcia
- Spanish Regional Government Navarra
- Catalan Institute of Oncology
- CIBER en Epidemiologia y Salud Publica, Spain
- ISCIII RETIC, Spain [RD06/0020]
- Cancer Research UK
- Medical Research Council, United Kingdom
- Stroke Association, UK
- British Heart Foundation
- Department of Health, UK
- Food Standards Agency, UK
- Wellcome Trust, UK
- Greek Ministry of Health
- Greek Ministry of Education
- Italian Association for Research on Cancer (AIRC)
- Italian National Research Council, Italy
- Fondazione-Istituto Banco Napoli, Italy
- Compagnia di San Paolo
- Dutch Ministry of Public Health, Welfare and Sports
- World Cancer Research Fund
- Swedish Cancer Society
- Swedish Scientific Council
- Regional Government of Skane, Sweden
- Cancer Research UK [14136] Funding Source: researchfish
- Medical Research Council [G1000143, G0401527] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
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Background: Smoking is not associated with prostate cancer incidence in most studies, but associations between smoking and fatal prostate cancer have been reported. Methods: During 1992 and 2000, lifestyle information was assessed via questionnaires and personal interview in a cohort of 145112 European men. Until 2009, 4623 incident cases of prostate cancer were identified, including 1517 cases of low-grade, 396 cases of high grade, 1516 cases of localised, 808 cases of advanced disease, and 432 fatal cases. Multivariable Cox proportional hazards regression models were used to examine the association of smoking status, smoking intensity, and smoking duration with the risk of incident and fatal prostate cancer. Results: Compared with never smokers, current smokers had a reduced risk of prostate cancer (RR = 0.90, 95% CI: 0.83-0.97), which was statistically significant for localised and low-grade disease, but not for advanced or high-grade disease. In contrast, heavy smokers (25+ cigarettes per day) and men who had smoked for a long time (40+ years) had a higher risk of prostate cancer death (RR = 1.81, 95% CI: 1.11-2.93; RR = 1.38, 95% CI: 1.01-1.87, respectively). Conclusion: The observation of an increased prostate cancer mortality among heavy smokers confirms the results of previous prospective studies.
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