Smoking and prostate cancer in a multi-ethnic cohort

Prostate. 2013 Oct;73(14):1518-28. doi: 10.1002/pros.22699. Epub 2013 Jul 3.


Background: Prostate cancer (PCa) and smoking-related morbidity disproportionately burdens African American (AA) men. Smoking is associated with high-grade PCa and incidence, but few studies have focused on AA men. This study aims to determine the effect of tobacco-use on odds of PCa and of high-grade PCa in a population of predominantly AA men.

Methods: This is a cross-sectional study evaluating smoking and PCa status in men with incident PCa and screened healthy controls. Altogether, 1,085 men (527 cases and 558 controls), age ≥ 40 years were enrolled through outpatient urology clinics in two US cities from 2001 to 2012. Validated questionnaires were used to gather clinical and socioeconomic data.

Results: The cases and controls were predominantly AA (79.9% and 71.3%, respectively, P = 0.01). AA men smoked more frequently (53.4% vs. 47.9%, P < 0.001) and quit less frequently than European American (EA) men (31.5% vs. 40.4%, P = 0.01). AA heavy smokers had increased odds of PCa diagnosis (OR 2.57, 95% CI 1.09, 6.10) and high-grade cancer (OR 1.89, 95% CI 1.03, 3.48) relative to never smokers and light smokers. Among AAs, heavy smokers had lower odds of NCCN low PCa recurrence risk stratification. AA former smokers had a trend for increased odds of high-grade cancer compared to never smokers. The associations between smokings, cancer diagnosis and cancer grade did not reach statistical significance in EA men.

Conclusion: We found ethnic differences in smoking behavior. Heavy smoking is associated with increased odds of PCa and of higher Gleason grade in AA men.

Keywords: African American; cancer disparities; prostate cancer; smoking.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • African Americans / psychology
  • African Americans / statistics & numerical data
  • Aged
  • Cross-Sectional Studies
  • European Continental Ancestry Group / psychology
  • European Continental Ancestry Group / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Odds Ratio
  • Prostate-Specific Antigen / analysis*
  • Prostatic Neoplasms* / diagnosis
  • Prostatic Neoplasms* / epidemiology
  • Prostatic Neoplasms* / etiology
  • Risk Factors
  • Smoking* / adverse effects
  • Smoking* / ethnology
  • United States


  • Prostate-Specific Antigen