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Clinical Research

Total and beverage-specific alcohol intake and the risk of aggressive prostate cancer: a case–control study



Ethanol in alcoholic beverages is a known carcinogen, but its association with aggressive prostate cancer (APC) is uncertain. Recent studies have shown a modest increase in risk of APC associated with heavy alcohol intake while association for beverage types remain inconsistent.


Using a case–control design and self-administered questionnaire, we examined the association between APC (high grade and/or advanced stage) and frequency and quantity of alcohol intake 2 years prior to enrolment. Furthermore, we delineated the relationships for beverage-specific intakes of beer, red wine, white wine and spirits.


The study included 1282 APC cases and 951 controls. Beer intake frequency of 5 days per week was associated with increased risk compared with no beer intake (odds ratio=1.66, 95% confidence interval: 1.12–2.48) whereas wine was protective at all frequencies of consumption compared with those with no wine intake. For every 10 g per week ethanol intake from beer increase, the odds of advanced PC rose by 3% (OR=1.03, 95% CI: 1.02–1.05). No such increased risk was observed for red or white wine while a marginal dose–response relationship was found for spirits (OR=1.03, 95% CI: 0.99–1.07).


Heavy beer and possibly spirits consumption is associated with increased risk while no dose–response relationship was found for red or white wine. Wine drinkers at all frequencies have a decreased risk of APC compared with those who did not drink wine.

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  1. Gronberg H . Prostate cancer epidemiology. Lancet 2003; 361: 859–864.

    Article  Google Scholar 

  2. IARC Working Group on the Evaluation of Carcinogenic Risk to HumansAlcohol Consumption and Ethyl Carbamate. International Agency for Research on Cancer: Lyon, FR, 2010. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 96).

  3. Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Bouvard V et al. Carcinogenicity of alcoholic beverages. Lancet Oncol 2007; 8: 292–293.

    Article  Google Scholar 

  4. Rota M, Scotti L, Turati F, Tramacere I, Islami F, Bellocco R et al. Alcohol consumption and prostate cancer risk: a meta-analysis of the dose-risk relation. Eur J Cancer Prev 2012; 21: 350–359.

    Article  Google Scholar 

  5. Loeb S, Bjurlin MA, Nicholson J, Tammela TL, Penson DF, Carter HB et al. Overdiagnosis and overtreatment of prostate cancer. Eur Urol 2014; 65: 1046–1055.

    Article  Google Scholar 

  6. Sakr WA, Grignon DJ, Crissman JD, Heilbrun LK, Cassin BJ, Pontes JJ et al. High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20-69: an autopsy study of 249 cases. In Vivo 1994; 8: 439–443.

    CAS  PubMed  Google Scholar 

  7. Dickerman BA, Markt SC, Koskenvuo M, Pukkala E, Mucci LA, Kaprio J . Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins. Cancer Causes Control 2016; 27: 1049–1058.

    Article  Google Scholar 

  8. Sawada N, Inoue M, Iwasaki M, Sasazuki S, Yamaji T, Shimazu T et al. Alcohol and smoking and subsequent risk of prostate cancer in Japanese men: the Japan Public Health Center-based prospective study. Int J Cancer 2014; 134: 971–978.

    CAS  Article  Google Scholar 

  9. McGregor SE, Courneya KS, Kopciuk KA, Tosevski C, Friedenreich CM . Case-control study of lifetime alcohol intake and prostate cancer risk. Cancer Causes Control 2013; 24: 451–461.

    Article  Google Scholar 

  10. Gong Z, Kristal AR, Schenk JM, Tangen CM, Goodman PJ, Thompson IM . Alcohol consumption, finasteride, and prostate cancer risk: results from the Prostate Cancer Prevention Trial. Cancer 2009; 115: 3661–3669.

    CAS  Article  Google Scholar 

  11. Schoonen WM, Salinas CA, Kiemeney LA, Stanford JL . Alcohol consumption and risk of prostate cancer in middle-aged men. Int J Cancer 2005; 113: 133–140.

    CAS  Article  Google Scholar 

  12. Chao C, Haque R, Van Den Eeden SK, Caan BJ, Poon KY, Quinn VP . Red wine consumption and risk of prostate cancer: the California Men's Health Study. Int J Cancer 2010; 126: 171–179.

    CAS  Article  Google Scholar 

  13. Sutcliffe S, Giovannucci E, Leitzmann MF, Rimm EB, Stampfer MJ, Willett WC et al. A prospective cohort study of red wine consumption and risk of prostate cancer. Int J Cancer 2007; 120: 1529–1535.

    CAS  Article  Google Scholar 

  14. Australian Government Department of Health. 2012. Available at (accessed 1 May 2016).

  15. Australian Bureau of Statistics,2011. Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia,2011. Available at (accessed 3 June 2016).

  16. Australian Institute of Health and Welfare 2014National Drug Strategy Household Survey Detailed Report 2013. AIHW: Canberra,2013. Drug statistics series no. 28. Cat. no. PHE 183.

  17. Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer 2015; 112: 580–593.

    CAS  Article  Google Scholar 

  18. Baglietto L, Severi G, English DR, Hopper JL, Giles GG . Alcohol consumption and prostate cancer risk: results from the Melbourne collaborative cohort study. Int J Cancer 2006; 119: 1501–1504.

    CAS  Article  Google Scholar 

  19. Chang ET, Hedelin M, Adami HO, Gronberg H, Balter KA . Alcohol drinking and risk of localized versus advanced and sporadic versus familial prostate cancer in Sweden. Cancer Causes Control 2005; 16: 275–284.

    Article  Google Scholar 

  20. Platz EA, Leitzmann MF, Rimm EB, Willett WC, Giovannucci E . Alcohol intake, drinking patterns, and risk of prostate cancer in a large prospective cohort study. Am J Epidemiol 2004; 159: 444–453.

    Article  Google Scholar 

  21. Slattery ML, West DW . Smoking, alcohol, coffee, tea, caffeine, and theobromine: risk of prostate cancer in Utah (United States). Cancer Causes Control 1993; 4: 559–563.

    CAS  Article  Google Scholar 

  22. Watters JL, Park Y, Hollenbeck A, Schatzkin A, Albanes D . Alcoholic beverages and prostate cancer in a prospective US cohort study. Am J Epidemiol 2010; 172: 773–780.

    Article  Google Scholar 

  23. Fowke JH, Howard L, Andriole GL, Freedland SJ . Alcohol intake increases high-grade prostate cancer risk among men taking dutasteride in the REDUCE trial. Eur Urol 2014; 66: 1133–1138.

    CAS  Article  Google Scholar 

  24. Rohrmann S, Linseisen J, Key TJ, Jensen MK, Overvad K, Johnsen NF et al. Alcohol consumption and the risk for prostate cancer in the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev 2008; 17: 1282–1287.

    CAS  Article  Google Scholar 

  25. Shannon J, Phoutrides E, Palma A, Farris P, Peters L, Forester A et al. Folate intake and prostate cancer risk: a case-control study. Nutr Cancer 2009; 61: 617–628.

    CAS  Article  Google Scholar 

  26. Orywal K, Szmitkowski M . Alcohol dehydrogenase and aldehyde dehydrogenase in malignant neoplasms. Clin Exp Med 2016 (doi:10.1007/s10238-016-0408-3; e-pub ahead of print).

    Article  Google Scholar 

  27. Meadows GG, Zhang H . Effects of alcohol on tumor growth, metastasis, immune response, and host survival. Alcohol Res Curr Rev 2015; 37: 311–322.

    Google Scholar 

  28. Plante MK, Arscott WT, Folsom JB, Tighe SW, Dempsey RJ, Wesley UV . Ethanol promotes cytotoxic effects of tumor necrosis factor-related apoptosis-inducing ligand through induction of reactive oxygen species in prostate cancer cells. Prostate Cancer Prostatic Dis 2013; 16: 16–22.

    CAS  Article  Google Scholar 

  29. Soleas GJ, Diamandis EP, Goldberg DM . Resveratrol: a molecule whose time has come? And gone? Clin Biochem 1997; 30: 91–113.

    CAS  Article  Google Scholar 

  30. Jasinski M, Jasinska L, Ogrodowczyk M . Resveratrol in prostate diseases - a short review. Cent Eur J Urol 2013; 66: 144–149.

    Google Scholar 

  31. Brown VA, Patel KR, Viskaduraki M, Crowell JA, Perloff M, Booth TD et al. Repeat dose study of the cancer chemopreventive agent resveratrol in healthy volunteers: safety, pharmacokinetics, and effect on the insulin-like growth factor axis. Cancer Res 2010; 70: 9003–9011.

    CAS  Article  Google Scholar 

  32. Renehan AG, Zwahlen M, Minder C, O'Dwyer ST, Shalet SM, Egger M . Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis. Lancet 2004; 363: 1346–1353.

    CAS  Article  Google Scholar 

  33. Urpi-Sarda M, Jauregui O, Lamuela-Raventos RM, Jaeger W, Miksits M, Covas MI et al. Uptake of diet resveratrol into the human low-density lipoprotein. Identification and quantification of resveratrol metabolites by liquid chromatography coupled with tandem mass spectrometry. Anal Chem 2005; 77: 3149–3155.

    CAS  Article  Google Scholar 

  34. Doll R, Peto R, Hall E, Wheatley K, Gray R . Mortality in relation to consumption of alcohol: 13 years' observations on male British doctors. BMJ 1994; 309: 911–918.

    CAS  Article  Google Scholar 

  35. Jayasekara H, MacInnis RJ, Room R, English DR . Long-term alcohol consumption and breast, upper aero-digestive tract and colorectal cancer risk: a systematic review and meta-analysis. Alcohol Alcohol 2016; 51: 315–330.

    Article  Google Scholar 

  36. Friedman LA, Kimball AW . Coronary heart disease mortality and alcohol consumption in Framingham. Am J Epidemiol 1986; 124: 481–489.

    CAS  Article  Google Scholar 

  37. Skogen JC, Harvey SB, Henderson M, Stordal E, Mykletun A . Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Trondelag Health Study. Addiction 2009; 104: 1519–1529.

    Article  Google Scholar 

  38. French MT, Popovici I, Maclean JC . Do alcohol consumers exercise more? Findings from a national survey. Am J Health Promot 2009; 24: 2–10.

    Article  Google Scholar 

  39. Stockwell T, Chikritzhs T . Commentary: another serious challenge to the hypothesis that moderate drinking is good for health? Int J Epidemiol 2013; 42: 1792–1794.

    Article  Google Scholar 

  40. Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA et al. The 2014 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol 2016; 40: 244–252.

    PubMed  Google Scholar 

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This study was funded in part by NHMRC grant #623204. IDD is supported by an Australian National Health and Medical Research Council Practitioner Fellowship (APP1102604).

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Correspondence to G G Giles.

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Supplementary Information accompanies the paper on the Prostate Cancer and Prostatic Diseases website

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Papa, N., MacInnis, R., Jayasekara, H. et al. Total and beverage-specific alcohol intake and the risk of aggressive prostate cancer: a case–control study. Prostate Cancer Prostatic Dis 20, 305–310 (2017).

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