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Meta-Analysis
. 2010 Apr;100(4):693-701.
doi: 10.2105/AJPH.2008.150508. Epub 2009 Jul 16.

Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies

Michael Huncharek  1 , K Sue Haddock, Rodney Reid, Bruce Kupelnick
Affiliations
Meta-Analysis

Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies

Michael Huncharek et al. Am J Public Health. 2010 Apr.

Abstract

Objectives: We evaluated the relationship between smoking and adenocarcinoma of the prostate.

Methods: We pooled data from 24 cohort studies enrolling 21 579 prostate cancer case participants for a general variance-based meta-analysis. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated separately for mortality and incidence studies. We tested the robustness of effect measures and evaluated statistical heterogeneity with sensitivity analyses.

Results: In the pooled data, current smokers had no increased risk of incident prostate cancer (RR = 1.04; 95% CI = 0.87, 1.24), but in data stratified by amount smoked they had statistically significant elevated risk (cigarettes per day or years: RR = 1.22; 95% CI = 1.01, 1.46; pack years of smoking: RR = 1.11; 95% CI = 1.01, 1.22). Former smokers had an increased risk (RR = 1.09; 95% CI = 1.02, 1.16). Current smokers had an increased risk of fatal prostate cancer (RR = 1.14; 95% CI = 1.06, 1.19). The heaviest smokers had a 24% to 30% greater risk of death from prostate cancer than did nonsmokers.

Conclusions: Observational cohort studies show an association of smoking with prostate cancer incidence and mortality. Ill-defined exposure categories in many cohort studies suggest that pooled data underestimate risk.

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Figures

FIGURE 1
FIGURE 1
Results of literature search: overview of 24 cohort studies.
FIGURE 2
FIGURE 2
Forest plot of pooled results reflecting risk of incident prostate cancer among subjects stratified as current smokers: overview of 24 cohort studies.
See this image and copyright information in PMC

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