Prostate cancer and smoking: A review of case-control and cohort studies

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Abstract
BACKGROUND The purpose of this study was to undertake a systematic analysis of the relation between smoking and prostate cancer. METHODS All published case‐control and cohort studies including relevant data on this topic were collected. The magnitude of potential sources of divergent results among case‐control studies was estimated comparing current, former, and ever to never smokers, stratified by type of controls (hospital vs. population) and by race. Cohort studies were discussed individually. RESULTS Neither a clinically nor a statistically significant association between smoking and prostate cancer seems likely, but it cannot be ruled out entirely. The association between other purported risk factors and prostate cancer is not likely to be confounded by the incomplete measurement and control for smoking habits because smoking and prostate cancer are not related. CONCLUSIONS For a valid assessment of other risk factors in prostate cancer patients the collection of complete smoking information is therefore less critical than in patients with other diseases. For a definitive assessment of the effect of smoking on prostate cancer incidence and mortality however, future studies need to focus on the collection of information on lifetime smoking habits, including tar exposure.