Healthy lifestyle may attenuate lethal prostate cancer risk
medwireNews: Men with a high genetic risk for developing prostate cancer may be able to offset the risk for lethal disease by maintaining a healthy lifestyle, findings indicate.
The study data were presented in a poster by Anna Plym (Brigham and Women's Hospital, Boston, Massachusetts, USA) and colleagues at the virtual AACR Annual Meeting 2021.
They used a validated polygenic risk score to quantify the genetic risk for prostate cancer among 10,443 participants of the US Health Professionals Follow-up Study with available genotype data, and evaluated the incidence of overall and lethal prostate cancer in the cohort from the time of DNA collection in 1993–1999 or 2005–2006 until 2016.
Over a median follow-up of approximately 20 years, there were 2111 cases of prostate cancer and 238 lethal prostate cancer events (defined as metastatic disease or prostate cancer-specific death).
Plym and co-workers found that men in the highest genetic risk quartile were a significant 5.4-fold more likely to develop prostate cancer than those in the lowest quartile, while the risk for lethal disease was a significant 3.4-fold greater.
This risk for lethal prostate cancer was attenuated among men who followed a healthy lifestyle, as indicated by a score of 4–6 points on a validated lifestyle scale including components such as a healthy weight (<30 kg/m2), engaging in vigorous physical activity, and high consumption of tomatoes and fatty fish.
But the benefit afforded by a healthy lifestyle appeared to largely be restricted to men in the highest genetic risk quartile, such that the risk was a significant 46% lower for men with a score of 4–6 points at study entry than for those with a score of 0–2 points, while the cumulative lifetime incidence of lethal prostate cancer was a respective 3% and 6%.
Adherence to a healthy lifestyle did not affect the risk for overall prostate cancer, reported the team.
Commenting on the findings in a press conference, AACR Annual Meeting Program Chair Charles Swanton (The Francis Crick Institute, London, UK) said that a key question was why a healthy lifestyle only protected those in the highest genetic risk category.
He believes that “we need future validation in larger cohorts using similar thresholds and a biological mechanism that might explain [such] an interaction.”
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