NEW YORK (Reuters Health) - Smoking is an independent risk factor for prostate cancer, particularly aggressive types, investigators in Seattle, Washington, report. Early smoking cessation seems to abrogate the increased risk, however.

In a population-based, case-control study, Dr. Janet L. Stanford, of the Fred Hutchinson Cancer Research Center, and colleagues focused on men below age 65. They interviewed 753 men who were diagnosed with prostate cancer between 1993 and 1996 and 703 age-matched controls without prostate cancer. They describe their data analysis in the July issue of Cancer Epidemiology, Biomarkers and Prevention.

Overall, current smokers had an odds ratio of 1.4 for prostate cancer compared with non-smokers, after adjusting for age, race, family history, benign prostatic hypertrophy, and screening history. There was a significant trend for declining risk with increasing years since smoking cessation (p = 0.02).

Among those who smoked more than 40 pack-years, the risk for any prostate cancer was increased 60%. However, their risk was doubled for developing regional or distant stage disease or tumors with a Gleason score 8 to 10.

Smoking was associated with higher levels of total testosterone and sex-hormone-binding globulin. Furthermore, cigarettes contain significant levels of cadmium, Dr. Stanford told Reuters Health, "and there is evidence that cadmium may interact with androgen receptors to cause higher androgen activity."

Her group's findings may represent a stronger inducement to stop smoking than other recognized risks, she surmised, because the incidence of prostate cancer is so much higher than that of many other smoking-related cancers. "There aren't a lot of risk factors for this disease that men can control, but smoking is one of those," she said.

Cancer Epidemiol Biomarkers Prev 2003;12:604-609.

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