Alcohol intake increases high-grade prostate cancer risk among men taking dutasteride in the REDUCE trial
BACKGROUND: Although most studies found no association between alcohol intake and prostate cancer (PCa) risk, an analysis of the Prostate Cancer Prevention Trial found that high alcohol intake significantly increased PCa risk among men randomized to the 5alpha-reductase inhibitor (5-ARI) finasteride.
OBJECTIVE: Determine whether alcohol affects PCa risk among men taking the 5-ARI dutasteride. DESIGN, SETTINGS, AND PARTICIPANTS: Reduction by Dutasteride of Prostate Cancer Events was a 4-yr, multicenter, randomized, double-blind, placebo-controlled trial to compare PCa after dutasteride administration (0.5mg/d) with placebo. Participants had a baseline prostate-specific antigen between 2.5 and 10.0 ng/ml and a recent negative prostate biopsy. Alcohol intake was determined by baseline questionnaire, and participants underwent a prostate biopsy to determine PCa status at 2 yr and 4 yr of follow-up.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between alcohol intake and low-grade (Gleason <7) and high-grade (Gleason >7) PCa.
RESULTS AND LIMITATIONS: Of 6374 participants in our analysis, approximately 25% reported no alcohol consumption, 49% were moderate drinkers (one to seven drinks per week), and 26% were heavy drinkers (more than seven drinks per week). Alcohol intake was not associated with low- or high-grade PCa in the placebo arm and was not associated with low-grade PCa among men taking dutasteride. In contrast, men randomized to dutasteride and reporting more than seven drinks per week were 86% more likely to be diagnosed with high-grade PCa (p=0.01). Among alcohol abstainers, dutasteride was associated with significantly reduced risk of high-grade PCa (OR: 0.59; 95% CI, 0.38-0.90), but dutasteride was no longer associated with reduced high-grade PCa among men reporting high alcohol intake (OR: 0.99; 95% CI, 0.67-1.45).
CONCLUSIONS: Alcohol consumption negated a protective association between dutasteride and high-grade PCa. PATIENT SUMMARY: We confirmed a prior study that alcohol affects PCa prevention in patients taking 5-ARIs. Patients taking 5-ARIs may wish to eliminate alcohol intake if they are concerned about PCa.
Additional Info
-
Authors
Fowke J.H.; Howard L.; Andriole G.L.; Freedland S.J. -
Issue
Eur.Urol. / pages 1133-1138 / volume 66 -
Published Date
december 2014
Related items
- Increasing rates of early-onset Luminal A breast cancers correlate with binge drinking patterns
- To Drink or Not to Drink? Investigating Alcohol’s Impact on Prostate Cancer Risk
- Alcohol Consumption and Cancer Risk: Two Sample Mendelian Randomization
- Joint association of drinking alcohol and obesity in relation to cancer risk: A systematic review and data synthesis
- Alcohol and colorectal cancer risk, subclassified by mutational signatures of DNA mismatch repair deficiency