Smokers at higher risk of death from prostate cancer

Prostate cancer patients who are also smokers have a greater risk of death, an effect that is further exacerbated by obesity, reports a recent study.

In a pooled sample of 351,448 men with available smoking information, researchers performed Cox regression analysis to assess the risk of prostate cancer incidence and death.

The analysis revealed that in the full cohort, current smokers saw a 10-percent higher risk of mortality than never smokers (hazard ratio [HR], 1.10, 95 percent confidence interval [CI], 1.02–1.18). This risk estimate was further aggravated in a case-only analysis adjusted for clinical parameters (HR, 1.20, 95 percent CI, 1.11–1.31). No such effect was reported for former smokers.

Moreover, smoking intensity and duration were both positively associated with the likelihood of prostate cancer death, while smoking cessation showed an inverse interaction. While none of the risk estimates achieved statistical significance, these results still served to reinforce the primary finding, the researchers said.

In addition, the combination of smoking and obesity further increased the risk of mortality (HR, 1.49, 95 percent CI, 1.21–1.84).

In contrast, smoking significantly to reduce the risk of prostate cancer incidence (HR, 0.89, 95 percent CI, 0.86–0.92), an effect made even stronger when combining obesity (HR, 0.40, 95 percent CI, 0.30–0.53).

Nevertheless, the researchers said that “[t]he lower prostate risk for smokers in the prostate-specific antigen era, particularly for low-risk prostate cancer, can probably be attributed to low uptake of PSA testing by smokers.”