饮酒与前列腺癌危险性关系的随访研究

Alcohol and prostate cancer in the NHANES Ⅰ:An epidemiologic follow-up study

目的对酒精的消费与前列腺癌的关系进行了随访研究。方法本研究为前瞻性的随机对照研究。研究对象根据年龄分为二个队列。队列1：从1991～1995年开始，包括了5766例男性，年龄25～74岁，平均随访时间为17年。队列2：从队列1抽取研究对象，从2002年开始到2004年，包括了3775例研究对象，平均随访时间9年。酒精消费的计算基线为患者平日的饮酒量，既往饮酒史为患者25、35、45和55岁饮酒情况。结果总共发生了254例前列腺肿瘤，与以前的大多数研究结果一致，酒精总的饮用量与前列腺癌没有明显关系（P〉0．05），但在第2队列中，重度饮酒和前列腺癌之间存在逆相关[（RR）=0．23，95％CI=0．06～0．95]，进一步研究发现；既往在25岁、35岁、45岁有大量饮酒的患者（每周〉25次），与前列腺癌的发生逆相关。结论研究结果说明既往有大量饮酒史与前列腺癌发生有关。

Objective We prospectively investigated the association between alcohol consumption and prostate cancer in the epidemiologic followup study （NHEFS） of the first National Health and Nutrition Examination Survey （NHANES I）o Methods There were two cohorts： 1） Cohort I, followed from baseline （1991 to 1995） through 2002, included 5766 men ages 25-74 years （median follow-up-17 years）; and 2） Cohort Ⅱ, followed from the first follow-up round for Cohort I （2002 to 2004） through 2002, included the 3775 men in Cohort I free of prostate cancer in 2002 to 2004 （median follow-up9 years）. Alcohol consumption was assessed at baseline as usual consumption, and at follow-up as usual consumption and as distant past consumption at the ayes of 25, 35, 45, and 55. Results There were 254 incident cases of prostate cancer. Consistent with most previous studies,we found no significant associations between usual total alcohol consumption and prostate cancer in Cohorts I or Ⅱ [p=non significant （NS）], except for a significant inverse association at the heaviest level of drinking in Cohort Ⅱ [relative risk （RR）=0.23, 95% confidence interval （CI=0.06-0.95] further study of heavy drinkers in Cohort 11 revealed significant inverse associations between distant past heavy drinking （defined as〉25 drinks/week） and prostate cancer at age 25 （RR = 0.20, 95% CI=0.06-0.63）, age 35 （RR=0.30, 95% CI=0.12-0.77）, and age 45 （RR = 0.39, 95% CI = 0.17-0.93）, but not at age 55 （RR = 0.43, 95% CI=0.17-1.10）. Conclusion These results suggest that it may be important to consider distant past consumption in etiologic studies of prostate cancer. However, our results were based nn small alcohol numbers and require replication.