Cancer Causes & Control

, Volume 27, Issue 9, pp 1049–1058 | Cite as

Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins

  • Barbra A. Dickerman
  • Sarah Coseo Markt
  • Markku Koskenvuo
  • Eero Pukkala
  • Lorelei A. Mucci
  • Jaakko KaprioEmail author
Original paper



Alcohol intake may be associated with cancer risk, but epidemiologic evidence for prostate cancer is inconsistent. We aimed to prospectively investigate the association between midlife alcohol intake and drinking patterns with future prostate cancer risk and mortality in a population-based cohort of Finnish twins.


Data were drawn from the Older Finnish Twin Cohort and included 11,372 twins followed from 1981 to 2012. Alcohol consumption was assessed by questionnaires administered at two time points over follow-up. Over the study period, 601 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between weekly alcohol intake and binge drinking patterns with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were performed to control for potential confounding by shared genetic and early environmental factors.


Compared to light drinkers (≤3 drinks/week; non-abstainers), heavy drinkers (>14 drinks/week) were at a 1.46-fold higher risk (HR 1.46; 95 % CI 1.12, 1.91) of prostate cancer, adjusting for important confounders. Among current drinkers, binge drinkers were at a significantly increased risk of prostate cancer (HR 1.28; 95 % CI 1.06, 1.55) compared to non-binge drinkers. Abstainers were at a 1.90-fold higher risk (HR 1.90; 95 % CI 1.04, 3.47) of prostate cancer-specific mortality compared to light drinkers, but no other significant associations for mortality were found. Co-twin analyses suggested that alcohol consumption may be associated with prostate cancer risk independent of early environmental and genetic factors.


Heavy regular alcohol consumption and binge drinking patterns may be associated with increased prostate cancer risk, while abstinence may be associated with increased risk of prostate cancer-specific mortality compared to light alcohol consumption.


Alcohol Binge drinking Prospective cohort study Prostate cancer Twins 



We are grateful to Kauko Heikkilä, Ph.Lic, for assistance in database management.


JK is supported by the Academy of Finland (Grants 265240 and 263278). SCM is supported by the National Cancer Institute at the National Institutes of Health Training Grant NIH T32 CA09001.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10552_2016_778_MOESM1_ESM.docx (100 kb)
Supplementary material 1 (DOCX 100 kb)


  1. 1.
    Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V et al (2015) Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis. Br J Cancer 112(3):580–593CrossRefPubMedGoogle Scholar
  2. 2.
    International Agency for Research on Cancer (2010) IARC monographs on the evaluation of carcinogenic risks to humans, vol 96, alcohol consumption and ethyl carbamate. IARC, LyonGoogle Scholar
  3. 3.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, WashingtonGoogle Scholar
  4. 4.
    Eriksson CJ (2015) Genetic-epidemiological evidence for the role of acetaldehyde in cancers related to alcohol drinking. Adv Exp Med Biol 815:41–58CrossRefPubMedGoogle Scholar
  5. 5.
    Jensen OM, Paine SL, McMichael AJ, Ewertz M (1996) Alcohol. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention, 2nd edn. Oxford University Press, New York, pp 290–318Google Scholar
  6. 6.
    Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, et al. European code against cancer 4th edition: alcohol drinking and cancer. Cancer Epidemiol. Published online ahead of print 2015. doi: 10.1016/j.canep.2015.01.007
  7. 7.
    Seitz HK, Mueller S (2015) Alcohol and cancer: an overview with special emphasis on the role of acetaldehyde and cytochrome P450 2E1. Adv Exp Med Biol 815:59–70CrossRefPubMedGoogle Scholar
  8. 8.
    Breslow RA, Weed DL (1998) Review of epidemiologic studies of alcohol and prostate cancer: 1971–1996. Nutr Cancer 30(1):1–13CrossRefPubMedGoogle Scholar
  9. 9.
    Dennis LK, Hayes RB (2001) Alcohol and prostate cancer. Epidemiol Rev 23(1):110–114CrossRefPubMedGoogle Scholar
  10. 10.
    Fillmore KM, Chikritzhs T, Stockwell T, Bostrom A, Pascal R (2009) Alcohol use and prostate cancer: a meta-analysis. Mol Nutr Food Res 53(2):240–255CrossRefGoogle Scholar
  11. 11.
    Rota M, Scotti L, Turati F, Tramacere I, Islami F, Bellocco R et al (2012) Alcohol consumption and prostate cancer risk. Eur J Cancer Prev 21(4):350–359CrossRefPubMedGoogle Scholar
  12. 12.
    Albertsen K, Grønbaek M (2002) Does amount or type of alcohol influence the risk of prostate cancer? Prostate 52(4):297–304CrossRefPubMedGoogle Scholar
  13. 13.
    Crispo A, Talamini R, Gallus S, Negri E, Gallo A, Bosetti C et al (2004) Alcohol and the risk of prostate cancer and benign prostatic hyperplasia. Urology 64(4):717–722CrossRefPubMedGoogle Scholar
  14. 14.
    Watters JL, Park Y, Hollenbeck A, Schatzkin A, Albanes D (2010) Alcoholic beverages and prostate cancer in a prospective US cohort Study. Am J Epidemiol 172(7):773–780CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    McGregor SE, Courneya KS, Kopciuk KA, Tosevski C, Friedenreich CM (2013) Case–control study of lifetime alcohol intake and prostate cancer risk. Cancer Causes Control 24(3):451–461CrossRefPubMedGoogle Scholar
  16. 16.
    Gong Z, Kristal AR, Schenk JM, Tangen CM, Goodman PJ, Thompson IM (2009) Alcohol consumption, finasteride, and prostate cancer risk: results from the Prostate Cancer Prevention Trial. Cancer 115(16):3661–3669CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Hayes RB, Brown LM, Schoenberg JB, Greenberg RS, Silverman DT, Schwartz AG (1996) Occupational risk factors and prostate cancer in US blacks and whites. Am J Epidemiol 143(7):692–697CrossRefPubMedGoogle Scholar
  18. 18.
    Platz EA, Leitzmann MF, Rimm EB, Willett WC, Giovannucci E (2004) Alcohol intake, drinking patterns, and risk of prostate cancer in a large prospective cohort study. Am J Epidemiol 159(5):444–453CrossRefPubMedGoogle Scholar
  19. 19.
    Putnam SD, Cerhan JR, Parker AS, Bianchi GD, Wallace RB, Cantor KP et al (2000) Lifestyle and anthropometric risk factors for prostate cancer in a cohort of Iowa men. Ann Epidemiol 10(6):361–369CrossRefPubMedGoogle Scholar
  20. 20.
    Sesso HD, Paffenbarger RS, Lee IM (2001) Alcohol consumption and risk of prostate cancer: The Harvard Alumni Health Study. Int J Epidemiol 30(4):749–755CrossRefPubMedGoogle Scholar
  21. 21.
    Tonnesen H, Moller H, Andersen JR, Jensen E, Juel K (1994) Cancer morbidity in alcohol abusers. Br J Cancer 69:327–332CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Velicer C, Kristal A, White E (2009) Alcohol use and the risk of prostate cancer: results from the VITAL cohort study. Nutr Cancer 56(1):50–56CrossRefGoogle Scholar
  23. 23.
    Sarna S, Kaprio J, Sistonen P, Koskenvuo M (1978) Diagnosis of twin zygosity by mailed questionnaire. Hum Hered 28(4):241–254CrossRefPubMedGoogle Scholar
  24. 24.
    National Institute on Alcohol Abuse and Alcoholism (NIHAAA). Drinking levels defined. Accessed 29 July 2015
  25. 25.
    Kujala UM, Kaprio J, Koskenvuo M (2002) Modifiable risk factors as predictors of all-cause mortality: the roles of genetics and childhood environment. Am J Epidemiol 156(11):985–993CrossRefPubMedGoogle Scholar
  26. 26.
    Baglietto L, Severi G, English DR, Hopper JL, Giles GG (2006) Alcohol consumption and prostate cancer risk: results from the Melbourne collaborative cohort study. Int J Cancer 119(6):1501–1504CrossRefPubMedGoogle Scholar
  27. 27.
    Haas GP, Sakr WA (1997) Epidemiology of prostate cancer. CA Cancer J Clin 47(5):273–287CrossRefPubMedGoogle Scholar
  28. 28.
    Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Gou Y, Ye Z et al (2014) Association between alcohol and cardiovascular disease: Mendelian randomization analysis based on individual participant data. BMJ 349:g4164CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Pogodin-Hannolainen D, Juusela H, Tammela TL, Ruutu M, Aro J, Määttänen L et al (2011) Prostate cancer screening: a survey of attitudes and practices among Finnish physicians in 1999 and 2007. J Med Screen 18:46–49CrossRefPubMedGoogle Scholar
  30. 30.
    Andriole GL, Crawford ED, Grubb RL, Buys SS (2009) Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 360:1310–1319CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Mäkinen T, Tammela TLJ, Hakama M, Stenman UH, Rannikko S, Aro J et al (2003) Tumor characteristics in a population-based prostate cancer screening trial with prostate-specific antigen. Clin Cancer Res 9:2435–2439PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Barbra A. Dickerman
    • 1
  • Sarah Coseo Markt
    • 1
  • Markku Koskenvuo
    • 2
  • Eero Pukkala
    • 3
    • 4
  • Lorelei A. Mucci
    • 1
  • Jaakko Kaprio
    • 2
    • 5
    • 6
    Email author
  1. 1.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA
  2. 2.Department of Public HealthUniversity of HelsinkiHelsinkiFinland
  3. 3.Finnish Cancer RegistryInstitute for Statistical and Epidemiological Cancer ResearchHelsinkiFinland
  4. 4.School of Health SciencesUniversity of TampereTampereFinland
  5. 5.Department of HealthNational Institute for Health and WelfareHelsinkiFinland
  6. 6.Institute for Molecular Medicine (FIMM)University of HelsinkiHelsinkiFinland

Personalised recommendations