To drink or not to drink? Investigating alcohol’s impact on prostate cancer risk
Prostate cancer (PCa) is one of the most commonly diagnosed cancers in men worldwide, with its incidence being particularly high in developed nations. In Europe, PCa is the most frequently diagnosed cancer among men and the third leading cause of cancer-related mortality.
One lifestyle factor that has drawn considerable attention in PCa research is the consumption of alcoholic beverages. While excessive intake is a well-known risk factor for several cancers, its association with PCa remains unclear and requires further exploration. Studies on this topic have produced inconsistent results: some research suggests that heavy alcohol consumption may increase the risk of PCa. In contrast, other studies report no association or even a potential protective effect, particularly with moderate wine consumption due to its polyphenol content.
The influence of ethanol on hormonal regulation may be responsible for these associations, particularly its impact on testosterone levels, as well as inflammation and oxidative stress, all of which are implicated in the development of prostate cancer. The challenge in disentangling the impact of alcohol on PCa is further compounded by the influence of lifestyle factors such as diet, smoking, etc. which may obscure or exaggerate the actual risk. In addition, the type of alcoholic beverage consumed, whether beer, wine, or spirits, may have varying effects on prostate health, possibly due to differences in metabolic processing and the presence of protective or harmful compounds. Given the contradictory evidence surrounding alcohol consumption and PCa, the current review aimed to provide more precise insights into how different patterns of alcohol consumption influence PCa risk.
The authors write that many of the inconsistencies in the findings on the association between alcohol consumption and prostate cancer can be attributed to variations in study design and potential biases. Studies that failed to account for confounding factors such as family history, concurrent medications, or lifestyle habits often reported no association between alcohol consumption and prostate cancer risk.
They concluded that the relationship between alcohol consumption and PCa is multifaceted, with evidence suggesting that excessive alcohol intake is linked to increased PCa risk, aggressiveness, and mortality. Conversely, moderate consumption of alcoholic beverages has shown more variable outcomes, potentially influenced by the type of alcoholic beverage, genetic factors, and metabolism pathways involving the alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH) enzymes. Alcohol’s impact on PSA levels can complicate early PCa detection. Methodological inconsistencies among studies, including variability in the measurement of alcohol consumption and lack of control for confounders, limit the current understanding.
