Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins-Beyond the Abstract

In a large, prospective study, we found that heavy regular alcohol consumption and binge drinking during midlife were significantly associated with an increased risk of prostate cancer risk. Men who were heavy drinkers (>14 drinks/week) were at a 46% higher risk of prostate cancer compared to those who were light drinkers (≤ 3 drinks/week).

Among current drinkers, binge drinkers – defined as consuming 5 or more drinks in one sitting at least once per month – were at a 28% increased risk of prostate cancer compared to non-binge drinkers. Intriguingly, we found that abstinence was associated with an increased risk of prostate cancer-specific mortality compared to light alcohol consumption. 

This study was conducted in a large population of Finnish twins with 30 years of follow-up data. This unique population of men included a wide range of alcohol consumption, and a high prevalence of heavy drinking and reported binge drinking. Moreover, the twin population allowed for the application of powerful analytic methods to control for potential familial confounding factors due to genetics and shared early environment. Our co-twin analyses suggested that alcohol consumption may be associated with prostate cancer risk independent of early environmental and genetic factors. 

The biologic mechanisms potentially linking alcohol and prostate cancer are complex. Heavy regular or binge drinking may increase prostate cancer risk through the production of carcinogenic metabolites such as acetaldehyde, promotion of oxidative stress, and enhancement of carcinogen solubility and absorption. Conversely, high alcohol intake may lower testosterone levels – an altered hormonal profile that might be expected to decrease prostate cancer risk. Further investigation is needed to explore how the balance between alcohol’s potentially adverse and protective effects varies by exposure level and how this impacts different stages of prostate carcinogenesis and grades of disease.

Written by: Barbra Dickerman 

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