Does early-life alcohol intake raise high-grade PCa risk?

Researchers studying alcohol consumption in men having prostate biopsies found those reporting heavy drinking earlier in life were more likely to have high-grade prostate cancer, whereas men’s current alcohol intake didn’t appear to impact the severity of their diagnoses.

“The World Cancer Research Fund recently issued a recommendation to avoid alcohol for the purposes of cancer prevention. This recommendation is based on the established role of alcohol in risk of oral and gastrointestinal cancers, and additional research is required to understand if alcohol plays a role in prostate cancer,” according to senior author Emma Allott, PhD, who conducted the research when she was an assistant professor of nutrition at the University of North Carolina Chapel Hill’s Gillings School of Global Public Health. Currently, Dr. Allott is a lecturer in molecular cancer epidemiology at Queen’s University Belfast, Northern Ireland.

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Despite increasing evidence that alcohol is a risk factor for many other cancer types, alcohol’s effect on prostate cancer is unclear. Studies looking at men’s current drinking and prostate cancer risk have yielded conflicting results. Researchers examining lifetime alcohol exposure and prostate cancer risk seem to show a positive association with low- and high-grade prostate cancer. Some of those studies have suggested an association between early-life alcohol consumption and prostate cancer, but few researchers have looked specifically how drinking early in life might impact prostate cancer or cancer grade later.

“Potentially, research studies assessing alcohol intake around the time of prostate cancer diagnosis may miss any effect of alcohol on prostate cancer,” Dr. Allott said.

The evidence suggests that prostate carcinogenesis might span decades, which makes considering early-life alcohol exposure important for better understanding prostate cancer etiology, the authors wrote. The study was published in Cancer Prevention Research (Aug. 23, 2018 [epub ahead of print]).

Dr. Allott and co-authors studied data from a racially diverse cohort of 650 men undergoing a prostate biopsy at the Durham Veterans Affairs Medical Center between January 2007 and January 2018. Men in the study completed a questionnaire about how much alcohol they consumed, from none to seven or more drinks weekly, during each decade of their lives.

Next:What the authors foundThey found that men who drank seven or more drinks weekly at ages 15 to 19 years were 3.2 times more likely to be diagnosed with high-grade prostate cancer later in life compared to non-drinkers. The authors noted similar associations between heavier drinking and prostate cancer severity for ages 20 to 29, 30 to 39, and 40 to 49 years. Men with a cumulative lifetime intake of seven or more alcoholic beverages weekly also were 3.2 times more likely than lifetime nondrinkers to have high-grade prostate cancer later in life.

There was no association, however, between alcohol intake at ages 15 to 19 years and overall prostate cancer diagnosis at biopsy. And current alcohol consumption was not significantly associated with high-grade prostate cancer.

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The authors concluded that their results suggest earlier-life and cumulative alcohol consumption might be important considerations when analyzing prostate cancer risk. But it’s premature to make any recommendations based on the results of this study, alone. Further research is needed, according to Dr. Allott.

“Currently, little is known about how alcohol may influence prostate cancer risk and progression. As such, it may be too soon for urologists to counsel their patients about alcohol with respect to prostate cancer,” Dr. Allott told Urology Times.“However, alcohol is also linked with other heath conditions, including liver disease, which may affect men at risk of, or living with, prostate cancer. Therefore, assessment of drinking patterns is still relevant in this population, irrespective of the relationship between alcohol and prostate cancer.”

Among the study’s limitations, it relied on self-reported data, which is subject to bias.