This study aims to assess the impact of healthy lifestyle on prostate cancer (PCa) risk in a diverse population.
Data for 281,923 men from the Million Veteran Program (MVP), a nationwide, health system-based cohort study, were analyzed. Self-reported information at enrollment included smoking status, exercise, diet, family history of PCa, and race/ethnicity. Body mass index (BMI) was obtained from clinical records. Genetic risk was assessed via a validated polygenic score. Cox proportional hazards models were used to assess associations with PCa outcomes.
After accounting for ancestry, family history, and genetic risk, smoking was associated with an increased risk of metastatic PCa (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.64-2.02; p < 10-16) and fatal PCa (HR, 2.73; 95% CI, 2.36-3.25; p < 10-16). Exercise was associated with a reduced risk of fatal PCa (HR, 0.86; 95% CI, 0.76-0.98; p = .03). Higher BMI was associated with a slightly reduced risk of fatal PCa, and diet score was not independently associated with any end point. Association with exercise was strongest among those who had nonmetastatic PCa at MVP enrollment. Absolute reductions in the risk of fatal PCa via lifestyle factors were greatest among men of African ancestry (1.7% for nonsmokers vs. 6.1% for smokers) or high genetic risk (1.4% for nonsmokers vs. 4.3% for smokers).
Healthy lifestyle is minimally related to the overall risk of developing PCa but is associated with a substantially reduced risk of dying from PCa. In multivariable analyses, both exercise and not smoking remain independently associated with reduced metastatic and fatal PCa.
Cancer. 2024 Jun 12 [Epub ahead of print]
Meghana S Pagadala, Asona Lui, Julie Lynch, Roshan Karunamuni, Kyung Min Lee, Anna Plym, Brent S Rose, Hannah Carter, Adam S Kibel, Scott L DuVall, Jason Vassy, J Michael Gaziano, Matthew S Panizzon, Richard L Hauger, Tyler M Seibert
Research Service, Veterans Affairs (VA) San Diego Healthcare System, San Diego, California, USA., Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA., VA Informatics and Computing Infrastructure, VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA., Department of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA., Department of Medicine, University of California San Diego, La Jolla, California, USA., VA Boston Healthcare System, Boston, Massachusetts, USA., Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts, USA.