Development and Application of a Lifestyle Score for Prevention of Lethal Prostate Cancer.

BACKGROUND - Several lifestyle factors have been associated with risk of lethal prostate cancer, but little is known about their combined effect. Our objective was to develop and apply a lifestyle score for prevention of lethal prostate cancer.

METHODS - We developed a lifestyle score among 42 701 men in the Health Professionals Follow-up Study (HPFS) followed from 1986 to 2010 and applied it among 20 324 men in the Physicians' Health Study (PHS) followed from 1982 to 2010. One point was given for each of: not currently smoking or quit 10 or more years ago, body mass index under 30kg/m(2), high vigorous physical activity, high intake of tomatoes and fatty fish, and low intake of processed meat. Diet-only scores (range = 0-3) and total scores (range = 0-6) were calculated. We used multivariable Cox proportional hazards regression to estimate the risk of lethal prostate cancer, adjusting for potential risk factors of lethal prostate cancer. All statistical tests were two-sided.

RESULTS - We observed 576 lethal prostate cancer events in HPFS and 337 in PHS. Men with 5-6 vs 0-1 points had a 68% decreased risk of lethal prostate cancer (hazard ratio [HR] = 0. 32, 95% confidence interval [CI] = 0. 19 to 0. 52) in HPFS and a non-statistically significant 38% decreased risk (HR = 0. 62, 95% CI = 0. 30 to 1. 26) in PHS. For dietary factors only, men with 3 vs 0 points had a 46% decreased risk (HR = 0. 54, 95% CI = 0. 30 to 0. 96) in the HPFS and a non-statistically significant 30% decreased risk (HR = 0. 70, 95% CI = 0. 40 to 1. 23) in PHS.

CONCLUSIONS - Adhering to a healthy lifestyle, defined by not smoking, normal body weight, high physical activity, and a healthy diet, may lower risk of lethal prostate cancer.

Journal of the National Cancer Institute. 2015 Nov 17*** epublish ***

Stacey A Kenfield, Julie L Batista, Jaquelyn L Jahn, Mary Kathryn Downer, Erin L Van Blarigan, Howard D Sesso, Edward L Giovannucci, Meir J Stampfer, June M Chan

PubMed

Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC). , Department of Urology, University of California, San Francisco, San Francisco, CA (SAK, ELVB, JMC); Departments of Epidemiology (SAK, JLB, MKD, ELG, MJS), Nutrition (ELG, MJS), and Social and Behavioral Sciences (JLJ), Harvard School of Public Health, Boston, MA; Channing Division of Network Medicine (JLB, JLJ, MKD, MJS) and Division of Preventive Medicine (HDS), Brigham and Women's Hospital, Boston, MA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (ELVB, JMC).

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