Behavioral Risks - Alcohol use

Heavy Drinking Linked to Aggressive Prostate Cancer, Cancels Effect of Preventive Drug

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Heavy, daily alcohol consumption increases the risk of high-grade (aggressive) prostate cancer, according to new research from the University of California San Francisco. Heavy drinking also appears to make Proscar (finasteride) ineffective for reducing prostate cancer risk.

Up till now, the relationship between alcohol consumption and prostate cancer risk has been generally inconclusive, according to UCSF researcher Zhihong Gong Ph.D. He saw an opportunity to use data from a very largeĀ  prevention trial to examine the associations of total alcohol, type of alcoholic beverage, and drinking pattern with risks of total, low- and high-grade prostate cancer.

Dr. Gong and his team examined data from more than 2 thousand men in the 10 thousand man Prostate Cancer Prevention Trial (PCPT) who actually developed prostate cancer and compared their drinking habits with those of the more than 8 thousand men who remained free of prostate cancer throughout the study's eight year duration.

His team broke down the men's drinking patterns in terms of grams of alcolhol consumed and drinks per day and days per week. Participants who reported heavy alcohol consumption (50 or more grams alcoholl per day) and regular heavy drinking (4 or more drinks drinks per day on 5 or more days per week) were twice as likely or more to be diagnosed with high-grade prostate cancer (RR: 2.01, and 2.17, respectively). Less heavy drinking was not associated with risk.

The UCSF group also compared drinking patterns with treatment outcome among men enrolled on this placebo-controlled trial of the drug finasteride. They found finasteride's ability to lower prostate cancer risk was blocked in men drinking more than 50g alcohol per day.

Heavy, daily drinking, they conclude, increases the risk of high-grade prostate cancer and heavy drinking also makes finasteride ineffective for reducing prostate cancer risk.

Zhihong Gong, Alan R. Kristal, Jeannette M. Schenk, Catherine M. Tangen, Phyllis J. Goodman, and Ian M. Thompson.
Alcohol Consumption, Finasteride and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial
.
Cancer
, August 15, 2009

ABSTRACT

BACKGROUND: Current research is inconclusive regarding the relation between alcohol consumption and prostate cancer risk. In this study, the authors examined the associations of total alcohol, type of alcoholic beverage, and drinking pattern with the risk of total, low-grade, and high-grade prostate cancer. METHODS: Data for this study came from the 2129 participants in the Prostate Cancer Prevention Trial (PCPT) who had cancer detected during the 7-year trial and 8791 men who were determined by biopsy to be free of cancer at the trial end. Poisson regression was used to calculate relative risks (RRs) and 95% confidence intervals (95% CIs) for associations of alcohol intake with prostate cancer risk. RESULTS: Associations of drinking with high-grade disease did not differ by treatment arm. In combined arms, heavy alcohol consumption (> or =50 g of alcohol daily) and regular heavy drinking (> or =4 drinks daily on > or =5 days per week) were associated with increased risks of high-grade prostate cancer (RR, 2.01 [95% CI, 1.33-3.05] and 2.17 [95% CI, 1.42-3.30], respectively); less heavy drinking was not associated with risk. Associations of drinking with low-grade cancer differed by treatment arm. In the placebo arm, there was no association of drinking with risk of low-grade cancer. In the finasteride arm, drinking > or =50 g of alcohol daily was associated with an increased risk of low-grade disease (RR, 1.89; 95% CI, 1.39-2.56); this finding was because of a 43% reduction in the risk of low-grade cancer attributable to finasteride treatment in men who drank <50 g of alcohol daily and the lack of an effect of finasteride in men who drank > or =50 g of alcohol daily (P(interaction) = .03). CONCLUSIONS: Heavy, daily drinking increased the risk of high-grade prostate cancer. Heavy drinking made finasteride ineffective for reducing prostate cancer risk.

Behavioral Risks - Alcohol use