Cigarette smoking is not associated with prostate cancer diagnosis and aggressiveness: a cross sectional Italian study

BACKGROUND: The aim of our study is to explore the association between cigarette smoking and the risk of prostate cancer (PCa) diagnosis as well as high grade disease in men undergoing prostate biopsies. METHODS: From 2008 to 2016, we prospectively enrolled a consecutive series of men with no history of PCa undergoing prostate biopsies. Variables assessed the day of the biopsy included: Family history of PCa, age, body mass index (BMI), comorbidities, digital rectal examination (DRE), prostate volume, PSA, free PSA, smoking status, number of cigarette/day, smoking time, smoking starting age and smoking cessation. Smoking variables were evaluated as predictors of PCa and high grade PCa (Prognostic Grade Group >= 3) using adjusted logistic regression analyses. RESULTS: Overall 1080 patients were enrolled, out of them 499/1080/753 (46%) had never smoked; 168/1080/753 (16%) were smokers and 413/1080 (38%) were former smokers. Out of the 451/1080 (41%) patients with PCa 175/451 (39%) presented high grade disease. As expected family history, age, dyslipidemia, PSA, digital rectal examination and prostate volume were independent predictors of PCa. As well age, DRE, and PSA were independent predictors of high-grade disease. Smoking status (OR=0.983; CI: 0.689-1.402) and the associated variables were not independent predictors of PCa or high grade PCa (OR: 1.250; CI: 0.593-1.327). CONCLUSIONS: In our cross-sectional study, smoking is not predictive of PCa or high-grade disease. Further studies should evaluate if smoking could influence PCa diagnosis and aggressiveness.