Smoking Increases Risk of Fatal Prostate Cancer

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Recent cigarette smoking is associated with an increased risk of fatal prostate cancer, according to a new report.

Sheila Weinmann, PhD, of the Center for Health Research at Kaiser Permanente Northwest in Portland, Ore., and colleagues compared 768 men who died from prostate cancer and 929 randomly selected matched controls. All subjects belonged to one of four health maintenance organizations.

The researchers examined medical records to obtain information on potential risk factors during the 10 years prior to the date on which prostate cancer was first suspected. They used the same reference dates for the matched controls.

Compared with individuals who never smoked, current smokers had a 50% increased risk of fatal prostate cancer, Dr. Weinmann's team reported in Cancer Causes and Control (2009; published online ahead of print). Former smokers were not at increased risk.

The investigators cited a previous paper suggesting that “smoking acts by hastening the course of prostate cancer, such that prostate cancer in smokers follows a more aggressive path than in nonsmokers” (Epidemiol Rev. 2001;23:115-125).

Dr. Weinmann's team also found that fatal prostate cancer was not significantly associated with greater weight, high BMI, diabetes, prostatitis, transurethral resection of the prostate, vasectomy, or a personal history of any cancer prior to the time of prostate cancer diagnosis.

The researchers observed a modest association between fatal prostate cancer and a history of benign prostatic hyperplasia (BPH) within two years before prostate cancer diagnosis, but no association with BPH diagnosed earlier.

African-American men who had a hypertension for 8.4 years or longer had a twofold elevated risk of fatal prostate cancer compared with subjects without hypertension.

“This study is important because it confirms a previously-suspected association between smoking and fatal prostate cancer,” Dr. Weinmann said. “This information may help prevent future prostate cancer deaths.” 

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