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Early-life heavy alcohol consumption increases prostate cancer risk

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August 23, 2018

Men who drank at least seven drinks per week between ages 15 to 49 years had a more than threefold greater likelihood for developing high-grade prostate cancer than men who did not drink, according to published findings.

However, current alcohol consumption was not associated with prostate cancer risk.

“Our results may explain why previous evidence linking alcohol intake and prostate cancer has been somewhat mixed,” Emma Allott, PhD, assistant professor in the department of nutrition at the University of North Carolina at Chapel Hill, said in a press release. “It’s possible that the effect of alcohol comes from a lifetime intake, or from intake earlier in life, rather than alcohol patterns around the time of diagnosis of prostate cancer.”

Prostate cancer is the second leading cause of mortality among men in the United States.

Alcohol also has played a large role in mortality rates worldwide, with cancer as a prominent contributing factor.

Research has shown conflicting results on the relationship between alcohol and prostate cancer risk; an early meta-analysis reported no association, whereas subsequent meta-analyses reported a modest increase in prostate cancer risk among individuals who consumed higher amounts of alcohol.

Another case-control study showed current alcohol intake not to be associated with prostate cancer risk, but that cumulative lifetime intake increased risk for aggressive and nonaggressive prostate cancer, which suggested earlier alcohol exposure had a direct impact on prostate cancer risk.

“The prostate is an organ that grows rapidly during puberty, so it’s potentially more susceptible to carcinogenic exposure during the adolescent years,” Allott said in the release. “For this reason, we wanted to investigate if heavy alcohol consumption in early life was associated with the aggressiveness of prostate cancer later.”

The analysis included 650 patients aged 49 to 89 years (median age, 64 years; 54% non-white) with no prior history of prostate cancer who underwent a prostate biopsy at Durham Veterans Affairs Medical Center between January 2007 and January 2018.

Men who drank at least seven drinks per week between ages 15 to 49 years had a more than threefold greater likelihood for developing high-grade prostate cancer.
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Researchers administered questionnaires that measured the average number of alcoholic drinks consumed weekly — none, one to six, or seven or more — during each decade of life to determine age-specific and cumulative lifetime alcohol intake.

When aged 15 to 19 years, 49% of men reported not drinking, 43% consumed between one to six drinks per week, and 8% consumed more than seven drinks per week. Characteristics appeared balanced among these groups, except that men who consumed a minimum of seven drinks a week had higher smoking pack-years (median pack-years, no drinks: 5.5 vs. 7 drinks: 34.5; P < .001).

Overall, 325 men were diagnosed with prostate cancer. Of these, 238 had low-grade disease and 88 had high-grade disease.

Alcohol consumption was not associated with overall prostate cancer risk, or low-grade prostate cancer risk.

However, multivariate analysis indicated a 3.2-higher likelihood for high-grade prostate cancer among men who consumed a minimum of seven drinks per week when aged 15 to 19 years compared with men who did not drink during that age span (OR = 3.21; 95% CI, 1.22-8.41).

This association with high-grade prostate cancer risk persisted among men who drank seven or more drinks weekly when aged 20 to 29 years (OR = 3.14; 95% CI, 1.14-8.65), 30 to 39 years (OR = 3.09; 95% CI, 1.2-8), and 40 to 49 years (OR = 3.64; 95% CI, 1.45-9.15).

Current alcohol consumption did not appear to play a significant role in development of high-grade prostate cancer.

Men with a higher cumulative lifetime intake of alcohol had increased odds of high-grade prostate cancer diagnosis (OR = 3.2; 95%CI, 1.47-6.98).

Researchers cited potential recall bias and small sample size as limitations of the study.

“These data give insight into prostate cancer risk factors in general and how earlier in life exposures may be important to consider when analyzing prostate cancer risk,” researchers wrote. “Further studies should explore earlier-life exposure to alcohol to validate these result.” – by Melinda Stevens

Disclosures: The study was sponsored by the American Institute for Cancer Research, the Irish Cancer Society John Fitzpatrick Fellowship and the NIH. The authors report no relevant financial disclosures.

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