Mediterranean Diet and Prostate Cancer Risk and Mortality in the Health Professionals Follow-up Study
Kenfield SA, Dupre N, Richman EL, Stampfer MJ, Chan JM, Giovannucci EL.Eur Urol. 2013 Aug 13. pii: S0302-2838(13)00830-0. doi: 10.1016/j.eururo.2013.08.009. [Epub ahead of print]

Source

Department of Urology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Electronic address: KenfieldS@urology.ucsf.edu.

Abstract

BACKGROUND:

Prostate cancer (PCa) mortality rates are lower in the Mediterranean countries compared with northern Europe. Although specific components of the Mediterranean diet (Med-Diet) may influence PCa risk, few studies have assessed the traditional Med-Diet pattern with the risk of incident advanced or lethal PCa or with disease progression among men diagnosed with nonmetastaticPCa.

OBJECTIVE:

To determine whether the traditional Med-Diet pattern is associated with risk of incident advanced or lethal PCa and with PCa-specific and overall mortality among men with PCa.

DESIGN, SETTING, AND PARTICIPANTS:

We prospectively followed 47 867 men in the Health Professionals Follow-up Study followed from 1986 to 2010. The case-only analysis included 4538 men diagnosed with nonmetastaticPCa, followed from diagnosis to lethal outcome or to January 2010.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:

We used Cox proportional hazards models to examine traditional and alternative Med-Diet scores in relation to PCa incidence outcomes (advanced and lethal disease). In a case-only survival analysis, we examined postdiagnostic Med-Diet and risk of lethal (metastases or PCa death) and fatal PCa as well as overall mortality among men diagnosed with nonmetastatic disease.

RESULTS AND LIMITATIONS:

Between 1986 and 2010, 6220 PCa cases were confirmed. The Med-Diet was not associated with risk of advanced or lethal PCa. In the case-only analysis, there was no association between the Med-Diet after diagnosis and risk of lethal or fatal PCa. However, there was a 22% lower risk of overall mortality (hazard ratio: 0.78; 95% confidence interval, 0.67-0.90; ptrend=0.0007) among men with greater adherence to the Med-Diet after PCa diagnosis. We found similar associations for the alternative score.

CONCLUSIONS:

A higher Med-Diet score was not associated with risk of advanced PCa or disease progression. Greater adherence to the Med-Diet after diagnosis of nonmetastaticPCa was associated with lower overall mortality.