Association of cigarette smoking with extraprostatic prostate cancer in young men

A few recent studies have revealed that cumulative or recent smoking is associated with death from prostate cancer suggesting that smoking may influence progression to more advanced disease. We evaluate the association of cigarette smoking with extraprostatic and/or Gleason sum 7 or greater prostate cancer in young men.

The study included men who underwent radical prostatectomy before age 55 years for prostate cancer between 1992 and 1999. A survey soliciting cigarette smoking history and other exposures was mailed to 498 eligible men. The response rate was 73%. Cases were defined as men with Gleason sum 7 or greater, extraprostatic or Gleason sum 7 or greater/extraprostatic disease based on pathologic analysis. All remaining participants were considered noncases for each case definition. We used logistic regression modeling to estimate the odds ratio (OR) for Gleason sum 7 or greater, extraprostatic and Gleason sum 7 or greater/extraprostatic disease with cigarette smoking.

Of the 352 respondents with a cigarette smoking history 5.4% were current smokers and 44.6% were former smokers at the time of surgery. The odds ratios of extraprostatic and Gleason sum 7 or greater/extraprostatic disease were 3.85 (95% CI 1.44-10.33) and 3.17 (95% CI = 1.13-8.85), respectively, for current smokers compared to men who never smoked. Evidence of an association of smoking with Gleason sum 7 or greater disease was limited. Risk of extraprostatic (p = 0.005) and Gleason sum 7 or greater/extraprostatic (p = 0.003) disease increased with increasing cumulative pack-years smoked. Higher cumulative smoking in the 10 years before surgery was associated with an increased risk of extraprostatic (p = 0.004) and Gleason sum 7 or greater/extraprostatic (p = 0.005) disease.

Cigarette smoking may influence the risk of extraprostatic prostate cancer in young men.