28 96
Review
–
Prostate
Cancer
Smoking
and
Prostate
Cancer:
A
Systematic Review
Cosimo De Nunzio
a , * ,Gerald
L.
Andriole
b ,Ian M.
Thompson
Jr
c ,Stephen
J.
Freedland
da
Department
of Urology,
Sant’Andrea Hospital, University
‘‘La
Sapienza’’,
Rome,
Italy;
b
Division
of Urology,
Barnes-Jewish Hospital, Washington University
School
of Medicine,
St.
Louis, MO, USA;
c
Department
of Urology,
The
Cancer
Therapy
and
Research
Center, University
of
Texas Health
Science
Center
at
San
Antonio, San Antonio TX, USA;
d
Section of Urology, Durham VA Medical Center and Division of Urology, Duke Prostate Cancer Centre, Departments of Surgery
and
Pathology, Duke
School
of Medicine, Durham, NC, USA
1.
Introduction
Prostate cancer
(PCa)
is
the
leading
cause of nonskin cancer
among men worldwide
and,
after
lung,
is
the
second most
common
cause
of
death
from
cancer
in men
in
the United
States
[1,2].
PCa
is
considered
a
chronic
disease with
early
initiation
and
slow
progression;
it
develops
through
early
and
late precancerous histologic modifications
[3] .The only
E U R O P E A N U R O L O G Y F O C U S 1 ( 2 0 1 5 ) 2 8 – 3 8available
at
www.sciencedirect.comjournal
homepage:
www.europeanurology.comArticle
info
Article
history:
Accepted October
21,
2014
Associate
Editor:
Tobias
Klatte
Keywords:
Prostate
Prostate
cancer
Smoking
Outcome
Treatment
Abstract
Context:
Cigarette
smoking
is
the
leading
cause
of
death
from
cancer,
although
the
relationship
between
smoking
and
prostate
cancer
(PCa)
is
controversial.
Objective:
To
evaluate
the
available
evidence
of
the
role
of
cigarette
smoking
and
PCa
development
and
progression
and
to
discuss
possible
clinical
implications
for
PCa
management.
Evidence acquisition:
A PubMed search
for relevant articles published between 2004 and
September
2014 was
performed
by
combining
the
following
PICO
(patient
population,
intervention,
comparison,
outcome)
terms:
male,
smoking,
prostate,
prostate
cancer,
pre-
vention,
diagnosis,
treatment
,
and
prognosis.
Preferred
Reporting
Items
for
Systematic
Reviews
and Meta-Analysis
guidelines were
followed.
Evidence
synthesis:
The
association
between
cigarette
smoking
and
PCa
incidence
is
controversial, particularly
in
recent
series. Current
cigarette
smoking
is associated with
an
increased
risk of PCa death, and
the number of cigarettes smoked per day had a dose–
response association with PCa mortality. Smokers present a higher risk of biochemical or
distant
failure after PCa
treatment. Several biological mechanisms behind
these associa-
tions have been proposed, although
the molecular mechanisms
remain unclear. Further
research
is
required
to better understand
the
role
of
smoking on
PCa development
and
progression and, particularly,
to evaluate
the possible effect of smoking cessation on PCa
management.
Conclusions:
Data
from
the peer-reviewed
literature
suggested an association of
smok-
ing
and
aggressive
PCa.
Although
the
pathophysiology
underlying
this
association
remains
unclear,
smokers
presented
higher
PCa mortality
and
worse
outcome
after
treatment. Smoking-cessation counseling should be
implemented
for patients with PCa,
although
its
effect
on
PCa
progression
should
be
investigated.
Patient
summary:
We
looked
at
the
association
between
smoking
and
prostate
cancer
(PCa).
Smokers
have
a
higher
risk
of
PCa mortality
and worse
outcomes
after
treatment.
Smoking
cessation
should be
encouraged
in men with or
at
risk of having PCa.
#
2015 European Association of Urology. Published by Elsevier B.V. All
rights
reserved.
* Corresponding
author.
Department
of
Urology,
Sant’Andrea
Hospital,
‘‘La
Sapienza’’
University,
Via
di Grottarossa
1035
-
00189,
Rome,
Italy.
Tel.
+39
0633777716;
Fax:
+39
0633775059.
address:
cosimodenunzio@virgilio.it(C. De Nunzio).
http://dx.doi.org/10.1016/j.euf.2014.10.0022405-4569/
#
2015
European
Association
of Urology.
Published
by
Elsevier
B.V.
All
rights
reserved.