Factors affecting the prognosis of prostate cancer in the United States: results from the national health and nutrition examination survey in 1999-2016

Abstract

Abstract Purpose Prostate cancer is one of the most harmful and widespread cancers in elderly men. This study aims to explore several common lifestyle factors that may influence the overall survival time among prostate cancer patients of different ethnic groups. Methods Data obtained from the National Health and Nutrition Examination Survey database (NHANES) between 1999 and 2016 was analyzed. Weighted multivariate cox regression and subgroup analysis were used to explore the underlying factors that affect the prognosis of prostate cancer. Kaplan-Meier survival curves were drawn to demonstrate the different survival time and survival rates in prostate cancer patients with different levels of exposure factors. Results A total of 639 prostate cancer patients were enrolled in this study. People with an earlier age of onset tended to have a longer survival time (P < 0.05). Non-Hispanic blacks seemed to be diagnosed with prostate cancer at an earlier stage (P < 0.05). Light to moderate alcohol consumption was a protective factor [HR 0.38, 95%CI:(0.16,0.89)] in Non-Hispanic Blacks with prostate cancer, which could provide longer overall survival time to prostate cancer patients than those who didn’t drink for at least one year. Smoking could be a harmful factor to the whole population [HR 2.37, 95%CI:(1.39,4.04)], while keeping BMI between 25 to 30 had protective effects [HR 0.62, 95%CI:(0.47,0.83)]. Non-Hispanic Whites were more likely to be affected by smoking [HR 3.24, 95%CI:(1.84,5.71)] and BMI [HR 0.57, 95%CI:(0.41,0.78)] compared to Non-Hispanic Blacks. Conclusion Appropriate overweight (BMI between 25 to 30) and mild to moderate alcohol consumption seemed to be protective factors in prostate cancer, while smoking showed a detrimental effect. The heterogeneity between ethnicities can’t be ignored and future more large-scale studies are required to verify our findings.