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Premorbid diet in relation to survival from prostate cancer (Canada)
D J Kim1, R P Gallagher, T G Hislop
1Department of Public Health Sciences, University of Toronto, ON, Canada.
Objectives:
To examine the associations between prediagnostic energy, fat, and vitamin A intake and survival from prostate cancer.
Methods:
Two hundred and seven cases of prostate cancer from Toronto and 201 cases from Vancouver provided diet histories at diagnosis between 1989 and 1992 and were followed for survival from prostate cancer. After exclusions for various reasons, 263 cases (135 from Toronto, 128 from Vancouver) were analyzed in Cox proportional hazards models.
Results:
Following adjustments for clinical stage, histologic grade, and other factors, significantly lower risks of dying from prostate cancer in the highest compared with the lowest tertiles of monounsaturated fat intakes were observed in each city and in the combined city analyses (combined cities: hazard ratio [HR] = 0.3; 95% confidence interval (CI) = 0.1-0.7). Survival from prostate cancer was significantly better for cases in the highest tertile of energy intake in Toronto (HR = 0.1; CI = 0.01-0.6) in contrast to that in Vancouver where these cases did relatively worse (HR = 2.6; CI = 0.6-10.7). Other nutrients were either not consistently or not significantly associated with prostate cancer survival in the two cities.
Conclusions:
This bi-center cohort study observed a consistent and significant inverse association between the premorbid intake of monounsaturated fat and risk of death from prostate cancer. The inconsistent results for energy intake between cities could potentially be attributed to non-respondent bias in Toronto.