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



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.

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  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):580–593

    CAS  Article  PubMed  Google 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, Lyon

    Google 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, Washington

    Google Scholar 

  4. 4.

    Eriksson CJ (2015) Genetic-epidemiological evidence for the role of acetaldehyde in cancers related to alcohol drinking. Adv Exp Med Biol 815:41–58

    Article  PubMed  Google 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 290–318

    Google 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 815:59–70

    Article  PubMed  Google Scholar 

  8. 8.

    Breslow RA, Weed DL (1998) Review of epidemiologic studies of alcohol and prostate cancer: 1971–1996. Nutr Cancer 30(1):1–13

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Dennis LK, Hayes RB (2001) Alcohol and prostate cancer. Epidemiol Rev 23(1):110–114

    CAS  Article  PubMed  Google 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):240–255

    CAS  Article  Google 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):350–359

    Article  PubMed  Google Scholar 

  12. 12.

    Albertsen K, Grønbaek M (2002) Does amount or type of alcohol influence the risk of prostate cancer? Prostate 52(4):297–304

    Article  PubMed  Google 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):717–722

    Article  PubMed  Google 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):773–780

    Article  PubMed  PubMed Central  Google 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):451–461

    Article  PubMed  Google 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):3661–3669

    CAS  Article  PubMed  PubMed Central  Google 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):692–697

    CAS  Article  PubMed  Google 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):444–453

    Article  PubMed  Google 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):361–369

    CAS  Article  PubMed  Google 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):749–755

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Tonnesen H, Moller H, Andersen JR, Jensen E, Juel K (1994) Cancer morbidity in alcohol abusers. Br J Cancer 69:327–332

    CAS  Article  PubMed  PubMed Central  Google 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):50–56

    Article  Google Scholar 

  23. 23.

    Sarna S, Kaprio J, Sistonen P, Koskenvuo M (1978) Diagnosis of twin zygosity by mailed questionnaire. Hum Hered 28(4):241–254

    CAS  Article  PubMed  Google 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):985–993

    Article  PubMed  Google 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):1501–1504

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Haas GP, Sakr WA (1997) Epidemiology of prostate cancer. CA Cancer J Clin 47(5):273–287

    CAS  Article  PubMed  Google 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:g4164

    Article  PubMed  PubMed Central  Google 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 18:46–49

    Article  PubMed  Google 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 360:1310–1319

    CAS  Article  PubMed  PubMed Central  Google 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 9:2435–2439

    PubMed  Google Scholar 

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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.

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Correspondence to Jaakko Kaprio.

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The authors declare that they have no conflicts of interest.

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Dickerman, B.A., Markt, S.C., Koskenvuo, M. et al. Alcohol intake, drinking patterns, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins. Cancer Causes Control 27, 1049–1058 (2016).

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  • Alcohol
  • Binge drinking
  • Prospective cohort study
  • Prostate cancer
  • Twins