Milk and Dairy Consumption among Men with Prostate Cancer and Risk of Metastases and Prostate Cancer Death

Andreas Pettersson; Julie L. Kasperzyk; Stacey A. Kenfield; Erin L. Richman; June M. Chan; Walter C. Willett; Meir J. Stampfer; Lorelei A. Mucci; Edward L. Giovannucci

doi:10.1158/1055-9965.EPI-11-1004

DOI: 10.1158/1055-9965.EPI-11-1004 Published March 2012

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Table 1.

Age-adjusted^a means and proportions among 3,918 men with prostate cancer by the 1st, 3rd, and 5th quintile of total dairy, low-fat dairy, and full fat dairy intake^b at start of follow-up

	Total dairy intake			Low-fat dairy intake			Full fat dairy
Characteristic	Q1	Q3	Q5	Q1	Q3	Q5	Q1	Q3	Q5
Median intake, serving/d	0.6	1.7	3.9	0.1	1.1	3.0	0.1	0.9	2.6
Age at diagnosis, y	68.3	69.1	69.8	68.7	68.6	69.8	69.4	69.2	69.3
Caucasian, %	93.9	97.2	98.0	94.0	96.4	98.4	94.6	96.6	97.3
Family history of prostate cancer, %	9.9	10.1	11.0	9.6	11.3	10.4	10.6	10.6	11.7
TNM stage, %
T1	54.9	58.1	56.6	55.0	56.0	56.9	55.9	54.8	55.1
T2	40.9	37.0	39.3	41.1	39.1	38.8	39.5	41.5	41.1
T3a	4.3	4.9	4.2	3.9	4.8	4.2	4.6	3.7	3.8
Gleason score, %
2–6	64.9	67.5	63.9	65.6	66.8	63.3	66.1	65.8	67.4
7	27.1	24.7	26.2	26.2	24.1	27.1	25.6	25.2	24.7
8–10	8.0	7.8	9.9	8.2	9.1	9.6	8.4	9.0	7.8
PSA at diagnosis, %
<10	71.8	72.5	68.7	69.6	71.3	70.1	71.8	71.2	67.7
10–20	19.8	18.8	21.5	20.6	18.8	19.7	19.0	20.2	22.7
>20	8.5	8.7	9.8	9.7	9.8	10.2	9.2	8.6	9.6
Treatment, %
Radical prostatectomy	48.3	51.6	49.3	46.4	50.1	50.0	49.9	48.8	48.5
Radiation therapy	36.7	33.1	36.0	37.4	35.8	36.1	35.1	38.0	35.4
Hormonal treatment	5.2	5.5	6.2	5.7	5.3	5.5	5.7	5.1	5.8
Active surveillance	7.2	8.1	7.0	8.0	7.4	7.0	7.8	6.3	8.3
Other	2.7	1.7	1.4	2.5	1.4	1.5	1.6	1.8	2.0
BMI, kg/m^b	25.6	25.7	26.0	25.9	25.6	25.8	25.2	25.8	26.2
Current smokers, %	4.7	4.0	6.1	5.6	4.2	4.7	3.0	5.4	5.6
Physical activity, MET-h/wk	34.8	33.9	37.3	33.5	34.7	36.3	36.2	34.8	36.5
Tomato sauce intake, servings/wk	1.0	1.1	1.0	1.0	1.1	1.0	1.0	1.1	1.1
α-linolenic acid intake, g/d	1.2	1.2	1.1	1.2	1.1	1.1	1.1	1.1	1.2
PSA screening, v%^c	95.1	94.4	95.5	93.1	96.8	95.9	97.3	94.1	94.9

↵^aAdjusted for age at prostate cancer diagnosis (<60, 60–64, 65–69, 70–74, and 75+).
↵^bQuintiles of servings per day.
↵^cEver had a PSA test for routine screening; restricted to men diagnosed after 1992.

Table 2.

Dairy intake and HRs and 95% CIs of lethal prostate cancer (N = 298) among 3,918 men with prostate cancer

Dairy product intake	No.	Model 1^a	Model 2^b	Model 3^c
Total milk, servings		HR (95% CI)	HR (95% CI)	HR (95% CI)
0–3/mo	44	1.00	1.00	1.00
>3/mo to 4/wk	57	0.87 (0.57–1.32)	0.90 (0.59–1.37)	1.01 (0.65–1.56)
>4/wk to 1/d	119	1.09 (0.76–1.58)	1.10 (0.75–1.59)	1.14 (0.77–1.69)
>1/d	78	0.96 (0.64–1.44)	0.95 (0.63–1.43)	0.89 (0.58–1.37)
P_trend		0.92	0.77	0.33
Skim to 2% fat milk, servings
0–3/mo	66	1.00	1.00	1.00
>3/mo to 4/wk	57	0.77 (0.53–1.12)	0.78 (0.54–1.15)	0.85 (0.57–1.27)
>4/wk to 1/d	104	0.86 (0.62–1.20)	0.84 (0.60–1.18)	0.86 (0.61–1.23)
>1/d	71	0.82 (0.57–1.19)	0.81 (0.56–1.18)	0.73 (0.49–1.09)
P_trend		0.62	0.57	0.17
Whole milk, servings
0–3/mo	264	1.00	1.00	1.00
>3/mo to 4/wk	13	0.87 (0.48–1.58)	0.83 (0.45–1.53)	0.89 (0.47–1.67)
>4/wk	21	2.07 (1.26–3.40)	2.09 (1.27–3.44)	2.15 (1.28–3.60)
P_trend		<0.01	<0.01	<0.01
Total dairy, quintiles^d, servings
1 (0 to 0.9/d)	60	1.00	1.00	1.00
2 (>0.9 to 1.3/d)	58	0.82 (0.56–1.21)	0.83 (0.56–1.23)	0.83 (0.55–1.25)
3 (>1.3 to 1.8/d)	58	0.80 (0.54–1.19)	0.80 (0.53–1.19)	0.96 (0.63–1.46)
4 (>1.8 to 2.9/d)	64	0.80 (0.54–1.19)	0.80 (0.53–1.20)	0.83 (0.54–1.27)
5 (>2.9/d)	58	0.71 (0.47–1.08)	0.70 (0.46–1.07)	0.68 (0.43–1.05)
P_trend		0.15	0.13	0.09
Low-fat dairy, quintiles^d, servings
1 (0 to 0.1/d)	65	1.00	1.00	1.00
2 (>0.1 to 0.6/d)	52	0.68 (0.46–1.01)	0.72 (0.49–1.07)	0.76 (0.50–1.14)
3 (>0.6 to 1.0/d)	60	0.80 (0.55–1.16)	0.81 (0.55–1.18)	0.83 (0.56–1.23)
4 (>1.0 to 1.4/d)	67	0.86 (0.59–1.24)	0.86 (0.59–1.26)	0.95 (0.64–1.41)
5 (>1.4/d)	54	0.67 (0.45–1.00)	0.68 (0.46–1.02)	0.62 (0.40–0.95)
P_trend		0.17	0.16	0.07
Full fat dairy, quintiles^d, servings
1 (0 to 0.2/d)	46	1.00	1.00	1.00
2 (>0.2 to 0.6/d)	72	1.58 (1.06–2.35)	1.57 (1.05–2.34)	1.50 (0.99–2.27)
3 (>0.6 to 1.0/d)	63	1.38 (0.92–2.08)	1.37 (0.90–2.07)	1.33 (0.86–2.06)
4 (>1.0 to 1.7/d)	55	1.07 (0.70–1.63)	1.06 (0.69–1.63)	1.04 (0.66–1.62)
5 (>1.7/d)	62	1.34 (0.87–2.06)	1.30 (0.83–2.04)	1.30 (0.82–2.07)
P_trend		0.91	0.95	0.95

↵^aAdjusted for age at diagnosis (continuous) and total caloric intake (quintiles).
↵^bAdjusted for variables in model 1 + smoking status (nonsmoker and smoker), BMI (<25, 25–29.9, and 30+), exercise in MET-h/wk (quintiles), tomato sauce intake (<1 serving/wk, 1–1.99 servings/wk, and 2- servings/wk), and α-linolenic acid intake (quintiles).
↵^cAdjusted for variables in model 1 + 2 + TNM stage (T1, T2, and T3a), Gleason score (<7, 7, >7, and unknown), and PSA at diagnosis (<10, 10–20, >20, and unknown).
↵^dCut points for quintiles of servings per day refer to the cut points for the baseline year, 1986. The cut points for the quintiles vary over time.

Table 3.

Dairy intake and multivariate HRs and 95% CIs of biochemical and clinical recurrence (N = 741) among 3,255 men with prostate cancer

Dairy product intake	No.	All men^a
Total milk, servings		HR (95% CI)
0–3/mo	128	1.00
>3/mo to 4/wk	154	0.98 (0.76–1.27)
>4/wk to 1/d	257	0.97 (0.76–1.22)
>1/d	202	1.08 (0.84–1.39)
P_trend		0.34
Skim to 2% fat milk, servings
0–3/mo	164	1.00
>3/mo to 4/wk	154	1.00 (0.79–1.28)
>4/wk to 1/d	239	0.92 (0.73–1.14)
>1/d	184	1.01 (0.79–1.28)
P_trend		0.77
Whole milk, servings
0–3/mo	670	1.00
>3/mo to 4/wk	34	1.19 (0.80–1.78)
>4/wk	37	1.51 (1.03–2.20)
P_trend		0.03
Total dairy, quintiles^b, servings
1 (0 to 0.9/d)	146	1.00
2 (>0.9 to 1.3/d)	149	0.99 (0.77–1.28)
3 (>1.3 to 1.8/d)	140	0.92 (0.71–1.19)
4 (>1.8 to 2.9/d)	139	0.96 (0.73–1.25)
5 (>2.9/d)	167	0.99 (0.76–1.29)
P_trend		0.93
Low-fat dairy, quintiles^b, servings
1 (0 to 0.1/d)	133	1.00
2 (>0.1 to 0.6/d)	144	1.22 (0.94–1.58)
3 (>0.6 to 1.0/d)	156	1.16 (0.90–1.50)
4 (>1.0 to 1.4/d)	149	1.23 (0.95–1.59)
5 (>1.4/d)	159	1.11 (0.86–1.45)
P_trend		0.81
Full fat dairy, quintiles^b, servings
1 (0 to 0.2/d)	153	1.00
2 (>0.2 to 0.6/d)	153	1.07 (0.83–1.37)
3 (>0.6 to 1.0/d)	147	0.92 (0.72–1.19)
4 (>1.0 to 1.7/d)	124	0.70 (0.54–0.92)
5 (>1.7/d)	164	1.02 (0.79–1.32)
P_trend		0.66

↵^aAdjusted for age at diagnosis (continuous), total caloric intake (quintiles), smoking status (nonsmoker and smoker), BMI (<25, 25–29.9, and 30+), exercise in MET-h/wk (quintiles), tomato sauce intake (<1 serving/wk, 1–1.99 servings/wk, and 2- servings/wk), α-linolenic acid intake (quintiles), TNM stage (T1, T2, and T3a), Gleason score (<7, 7, >7, unknown), and PSA at diagnosis (<10, 10–20, >20, and unknown).
↵^bCut points for quintiles of servings per day refer to the cut points for the baseline year, 1986. The cut points for the quintiles vary over time.