Joint effects of smoking and body mass index on prostate cancer risk

Between 1979 and 1985, a population-based case-control study of cancer at multiple sites was carried out in Montréal. A total of 399 cases with histologically confirmed prostate cancer and 476 population controls, 45-70 years of age, gave face-to-face interviews and provided adequate smoking histories. We analyzed the effects of smoking cigarettes only and of smoking cigars, or pipes, or both, with or without cigarettes, on the risk of prostate cancer. Overall, the associations between smoking cigarettes and prostate cancer were weak and compatible with no effect; the associations with cigar and pipe smoking were stronger. Among men with high body mass index, however, we found appreciable associations between cigarette smoking and prostate cancer risk. A history of ever smoking daily was associated with an odds ratio of 2.31 (95% confidence interval = 1.09-4.89). Risk increased with the amount smoked per day and with the duration of smoking. Taken together, the findings of increased risk associated with cigar and pipe smoking and the findings of increased risk associated with cigarette smoking among obese men suggest that tobacco smoking may be a risk factor for prostate cancer.