Abstract
BackgroundResearch on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive. Recent studies on associations between alcohol consumption and other health outcomes suggest these are influenced by drinker misclassification errors and other study quality characteristics. The influence of these factors on estimates of the relationship between alcohol consumption and prostate cancer has not been previously investigated.MethodsPubMed and Web of Science searches were made for case–control and cohort studies of alcohol consumption and prostate cancer morbidity and mortality (ICD–10: C61) up to December 2014. Studies were coded for drinker misclassification errors, quality of alcohol measures, extent of control for confounding and other study characteristics. Mixed models were used to estimate relative risk (RR) of morbidity or mortality from prostate cancer due to alcohol consumption with study level controls for selection bias and confounding.ResultsA total of 340 studies were identified of which 27 satisfied inclusion criteria providing 126 estimates for different alcohol exposures. Adjusted RR estimates indicated a significantly increased risk of prostate cancer among low (RR = 1.08, P < 0.001), medium (RR = 1.07, P < 0.01), high (RR = 1.14, P < 0.001) and higher (RR = 1.18, P < 0.001) volume drinkers compared to abstainers. There was a significant dose–response relationship for current drinkers (Ptrend < 0.01). Studies free from misclassification errors produced the highest risk estimates for drinkers versus abstainers in adjusted models (RR = 1.22, P < 0.05).ConclusionOur study finds, for the first time, a significant dose–response relationship between level of alcohol intake and risk of prostate cancer starting with low volume consumption (>1.3, <24 g per day). This relationship is stronger in the relatively few studies free of former drinker misclassification error. Given the high prevalence of prostate cancer in the developed world, the public health implications of these findings are significant. Prostate cancer may need to be incorporated into future estimates of the burden of disease alongside other cancers (e.g. breast, oesophagus, colon, liver) and be integrated into public health strategies for reducing alcohol related disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2891-z) contains supplementary material, which is available to authorized users.
Highlights
Research on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive
Compared to the “abstainers”, being a drinker at any level was associated with increased risk of prostate cancer (RR = 1.08, 95% CI: 1.04–1.12, P = 0.0033)
Meta–analyses of cohort and case–control studies were conducted to investigate (i) the role of alcohol consumption as a potential risk factor for prostate cancer and, (ii) whether this relationship was significantly influenced by key study characteristics and potential biases, in particular according to whether former and/or occasional drinkers were misclassified as abstainers
Summary
Research on a possible causal association between alcohol consumption and risk of prostate cancer is inconclusive. Recent studies on associations between alcohol consumption and other health outcomes suggest these are influenced by drinker misclassification errors and other study quality characteristics. The influence of these factors on estimates of the relationship between alcohol consumption and prostate cancer has not been previously investigated. Around 1.1 million cases were recorded in 2012, accounting for 15% of all new cases of cancer in men [2] It is most commonly diagnosed in high–income countries, where screening is common. It is the fifth most common cause of cancer death in men worldwide. Prostate cancer as a chronic disease has become an important public health concern
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