Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet
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ORIGINAL PAPER
Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH‑AARP Diet and Health Study Tuo Lan1 · Yikyung Park2,3 · Graham A. Colditz2,3 · Jingxia Liu2,3 · Molin Wang4,5,6 · Kana Wu7 · Edward Giovannucci5,6,7 · Siobhan Sutcliffe2,3 Received: 19 February 2020 / Accepted: 24 July 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Although a growing body of evidence supports an early-life contribution to prostate cancer (PCa) development, few studies have investigated early-life diet, and only three have examined early-life dairy product intake, a promising candidate risk factor because of its known/suspected influence on insulin-like growth factor levels and height. Methods We used recalled dietary data from 162,816 participants in the NIH-AARP Diet and Health Study to investigate associations for milk, cheese, ice cream, total dairy, and calcium intake at ages 12–13 years with incident total (n = 17,729), advanced (n = 2,348), and fatal PCa (n = 827) over 14 years of follow-up. We calculated relative risks (RRs) and 95% confidence intervals (CIs) by Cox proportional hazards regression. Results We observed suggestive positive trends for milk, dairy, and calcium intake with total and/or advanced PCa (p-trends = 0.016–0.148). These trends attenuated after adjustment for additional components of adolescent diet, particularly red meat and vegetables/potatoes. In contrast, suggestive inverse trends were observed for cheese and ice cream intake with total and/or advanced PCa (p-trends = 0.043–0.153), and for milk, dairy, and calcium intake with fatal PCa (p-trend = 0.045–0.117). Conclusion Although these findings provide some support for a role of adolescent diet in increasing PCa risk, particularly for correlates of milk intake or overall dietary patterns, our protective findings for cheese and ice cream intake with PCa risk and mortality, and for all dairy products with PCa mortality, suggest alternative explanations, such as the influence of early-life socioeconomic status, and increased PCa screening, earlier detection, and better PCa care. Keywords Prostate cancer · Diet · Dairy product · Calcium · Early life · Adolescent
Introduction An estimated 1,276,106 men were diagnosed and 358,985 died from prostate cancer (PCa) in 2018 worldwide, making it the second most common and fifth most lethal cancer * Siobhan Sutcliffe [email protected] 1
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Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
globally [1]. Despite persistent efforts to elucidate the etiology of PCa, few modifiable risk factors have been identified [2]. To date, most epidemiologic studies have focused on mid- to later-life exposures, but studying earlier-life exposures—for ins
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