Smoking and Prostate Cancer

Considering the high prevalence of smoking and the high prostate cancer morbidity this paper examines the relation between smoking and the risks of prostate cancer. In this regard a Medline search was conducted covering the period from 1966 to March 2000. Most of the prospective cohort studies and all case-control studies that used incident cases as the outcome found no association between current smoking and prostate cancer. On the other hand contrasting results were observed among majority of prospective cohort studies that used prostate cancer mortality as outcome. Findings from these studies found a positive association between current smoking and prostate cancer. Population-based case-control studies meanwhile produced null results which were attributed to differential measurement errors in mortality cohorts. However there were methodological shortcomings noted that affect the prostate cancer-smoking estimate of effect such as the surveillance bias misclassification of smoking status and uncontrolled confounding factors. Hence prospective studies should obtain detailed information on the clinical stage and histologic grade of prostate cancer and on the subjects smoking history.