title: Racial/ethnic differences in lifestyle-related factors and prostate cancer risk: the Multiethnic Cohort Study.
abstract: OBJECTIVE
  Older age, African ancestry, and family history of prostate cancer are well-established risk factors for prostate cancer, and all are non-modifiable. Various lifestyle factors have been examined in relation to prostate cancer risk, including diet, obesity, and physical activity; however, none of them has been consistently related to risk. In the Multiethnic Cohort Study, we investigated whether lifestyle-related factors are associated with prostate cancer risk and whether such factors explain the racial/ethnic differences in risk.
  
  
  METHODS
  During a mean follow-up of 13.9 years, 7,115 incident cases were identified among 75,216 white, African-American, Native Hawaiian, Japanese American, and Latino men. Cox proportional hazards models were used to calculate relative risks (RRs) and 95 % confidence intervals (95 % CIs) for prostate cancer.
  
  
  RESULTS
  Among selected lifestyle-related factors including body mass index, height, education, physical activity, and intakes of alcohol, calcium, legumes, lycopene, and selenium, only smoking (RR for current (≥20 cigarettes/day) vs. never smoking = 0.72; 95 % CI 0.63-0.83) and history of diabetes (RR for yes vs. no = 0.78; 95 % CI 0.72-0.85) were significantly associated with prostate cancer risk. Compared to whites, the risk of incident prostate cancer was twofold higher in African-Americans and 16 % higher in Latinos. Additional adjustment for a history of PSA testing did not change the results.
  
  
  CONCLUSIONS
  The findings suggest that racial/ethnic differences in prostate cancer risk are not explained by the lifestyle factors examined and that underlying genetic factors may be involved.
authors.affiliation: Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA. spark@cc.hawaii.edu.
authors.forename: Song-Yi
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Haiman
authors.affiliation: Cancer Prevention Institute of California, 2201 Walnut Avenue, Fremont, CA, 94538, USA.
authors.forename: Iona
authors.initials: I
authors.lastname: Cheng
authors.affiliation: Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
authors.forename: Sungshim Lani
authors.initials: SL
authors.lastname: Park
authors.affiliation: Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.affiliation: Office of Public Health Studies, University of Hawaii, 1960 East-West Road, Honolulu, HI, 96822, USA.
authors.forename: Laurence N
authors.initials: LN
authors.lastname: Kolonel
authors.affiliation: Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Marchand
authors.affiliation: Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Henderson
mesh_terms: D001741:Black or African American; D000368:Aged; D001213:Asian; D015331:Cohort Studies; D048909:Diabetes Complications; D006630:Hispanic or Latino; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander; D011471:Prostatic Neoplasms / Q000208:ethnology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D044465:White People
keywords: Cohort; Lifestyle factors; Multiethnic population; Prostate cancer; Racial/ethnic difference