Does Heavy Alcohol Use Increase Risk of Prostate Cancer?

To assess the effect of alcohol use on prostate cancer risk, researchers analyzed data from 10,920 men participating in the Prostate Cancer Prevention Trial. Participants age 55 years or older and without prostate cancer were randomized to receive either finasteride or placebo and followed for 7 years. Baseline questionnaire data on quantity, frequency, and type of alcohol consumed were used to calculate average grams of ethanol per day. At baseline, 79% of subjects reported no drinking, 12% reported consumption of 0.1–14.9 g alcohol per day, 6% reported consumption of 15–49.9 g per day, and 2.4% reported consumption of ≥50 g per day.

 

• Prostate cancer was diagnosed in 2129 men (19.5%) during follow-up. Of these, 67% had low-grade cancer (Gleason score, 2–6), 26.5% had high-grade cancer (Gleason score, 7–10), and 6.5% had cancer of unknown grade.

• Compared with no alcohol use, heavy use (≥50 g per day) was associated with a significantly increased risk of total, low-grade, and high-grade prostate cancer in the finasteride group (relative risk [RR]=1.89, 2.01, and 2.15, respectively) and with a nonsignificant increased risk of high-grade cancer in the placebo group (RR=1.67). Lower levels of alcohol use were not associated with increased prostate cancer risk.

• Heavy beer and wine use were associated with increased prostate cancer risk, but liquor was not.

Comments:

This interesting study suggests that heavy alcohol use may increase prostate cancer risk and may also prevent a beneficial effect of finasteride on that risk. It should be noted that the threshold for increased risk in this study (50 g per day) is equal to about 4 standard drinks per day and, therefore, well above published hazardous drinking thresholds for men. Still, these results may be useful to clinicians when counseling their patients about lower-risk alcohol use and/or prostate cancer prevention. Kevin L. Kraemer, MD, MSc

Reference:

Gong Z, Kristal AR, Schenk JM, et al. Alcohol consumption, finasteride, and prostate cancer risk. Cancer. 2009;115(16):3661–3669.