Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Christmas Island
Background: Previous research has suggested that benign prostatic hyperplasia might escalate the risk of prostate cancer. Uncertainty remains regarding whether adherence to healthy lifestyles could help men with benign prostatic hyperplasia prevent risk of prostate cancer.
Objectives: This study aimed to investigate the joint effect of healthy lifestyles on the risk of prostate cancer among men with benign prostatic hyperplasia.
Methods: Data was sourced from the UK Biobank cohort. Men with benign prostatic hyperplasia were recruited between March 21, 2006 and September 30, 2010 and followed until September 30th in 2021. Diagnosis of prostate cancer and benign prostatic hyperplasia were ascertained through linkage to Hospital Inpatient Records, Cancer Registry and the National Health Service. Information on exposure and covariates was collected through baseline questionnaires. The main exposure was lifestyle score, defined by nine lifestyles according to the latest evidence and ranged from 0 to 9, indicating zero to nine healthy lifestyles. Hazard ratios (HR) and 95% confidence intervals (CI) for the association of each lifestyle factor with incident prostate cancer were estimated by Cox regression, adjusted for age, Townsend deprivation index, body mass index, family history of cancer, systolic blood pressure, income, education and ethnicity among participants with complete data on the lifestyle.
Results: Among 10,228 men with benign prostatic hyperplasia and free of prostate cancer at baseline, 32.8% had more than three unhealthy lifestyle factors and the median lifestyle score was 2 [IQR:1-3]. After a median follow-up period of 12.4 years, 1044 (10.2%) incident prostate cancer cases were recorded. Nine healthy lifestyles, including no-current smoking, alcohol intake ≤ 4 times/week, sedentary time < 4h/day, ≥150 min moderate physical activity or 75 min vigorous activity/week physical activity, ≥7 and ≤9 h/day sleep duration, ≥400g of fruit or vegetables/day, ≥1 portion of oily fish/week, ≤3 portion of red meat/week, and ≤1 portion of processed meat/week, were not associated with reduced prostate cancer risk in men with benign prostatic hyperplasia (All P>0.05). The lifestyle score was not associated with reduced risk of prostate cancer, either (P>0.05).
Conclusions: Among men with benign prostatic hyperplasia, lifestyle factors might not associate with reduced risk of prostate cancer. The prevention of prostate cancer among men with benign prostatic hyperplasia might need medication.
