Zinc Intake and Risk of Prostate Cancer: Case-Control Study and Meta-Analysis

Zinc is an essential dietary element that has been implicated in the pathogenesis of prostate cancer, a cancer that disproportionately affects men of African descent. Studies assessing the association of zinc intake and prostate cancer have yielded inconsistent results. Furthermore, very little is known about the relationship between zinc intake and prostate cancer among African Americans. We examined the association between self-reported zinc intake and prostate cancer in a hospital-based case-control study of African Americans. We then compared our results with previous studies by performing a meta-analysis to summarize the evidence regarding the association between zinc and prostate cancer. Newly diagnosed African American men with histologically confirmed prostate cancer (n = 127) and controls (n = 81) were recruited from an urban academic urology clinic in Washington, DC. Controls had higher zinc intake, with a mean of 14 mg/day versus 11 mg/day for cases. We observed a non-significant, non-linear increase in prostate cancer when comparing tertiles of zinc intake (OR <6.5 vs 6.5–12.5mg/day 1.8, 95% CI: 0.6,5.6; OR <6.5 vs >12.5mg/day 1.3, 95% CI: 0.2,6.5). The pooled estimate from 17 studies (including 3 cohorts, 2 nested case-control, 11 case-control studies, and 1 randomized clinical trial, with a total of 111,199 participants and 11,689 cases of prostate cancer) was 1.07hi vs lo 95% CI: 0.98–1.16. Using a dose-response meta-analysis, we observed a non-linear trend in the relationship between zinc intake and prostate cancer (p for nonlinearity = 0.0022). This is the first study to examine the relationship between zinc intake in black men and risk of prostate cancer and systematically evaluate available epidemiologic evidence about the magnitude of the relationship between zinc intake and prostate cancer. Despite of the lower intake of zinc by prostate cancer patients, our meta-analysis indicated that there is no evidence for an association between zinc intake and prostate cancer.

[1]  I. Thompson,et al.  Plasma Vitamin D and Prostate Cancer Risk: Results from the Selenium and Vitamin E Cancer Prevention Trial , 2014, Cancer Epidemiology, Biomarkers & Prevention.

[2]  R. Uzzo,et al.  Zinc and zinc transporters in prostate carcinogenesis , 2013, Nature Reviews Urology.

[3]  B. Henderson,et al.  Serum zinc and prostate cancer risk in a nested case–control study: The multiethnic cohort , 2013, The Prostate.

[4]  Mohammed F. Faramawi,et al.  Increased Risk of Cancer Mortality Associated with Cadmium Exposures in Older Americans with Low Zinc Intake , 2013, Journal of toxicology and environmental health. Part A.

[5]  R. Rajikan,et al.  Association between trace element and heavy metal levels in hair and nail with prostate cancer. , 2012, Asian Pacific journal of cancer prevention : APJCP.

[6]  Christos T. Chasapis,et al.  Zinc and human health: an update , 2012, Archives of Toxicology.

[7]  J. Marshall Diet and prostate cancer prevention , 2012, World Journal of Urology.

[8]  J. Dwyer,et al.  Foods, Fortificants, and Supplements: Where Do Americans Get Their Nutrients? , 2011, The Journal of nutrition.

[9]  J. Carpten,et al.  EphB2 SNPs and Sporadic Prostate Cancer Risk in African American Men , 2011, PloS one.

[10]  A. Wolk,et al.  Dietary zinc and prostate cancer survival in a Swedish cohort. , 2011, The American journal of clinical nutrition.

[11]  R. Kittles,et al.  Prostate Cancer Susceptibility Loci Identified on Chromosome 12 in African Americans , 2011, PloS one.

[12]  O. Bagasra,et al.  Differential zinc accumulation and expression of human zinc transporter 1 (hZIP1) in prostate glands. , 2010, Methods.

[13]  I. Thompson,et al.  American Journal of Epidemiology Original Contribution Diet, Supplement Use, and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial , 2022 .

[14]  N. Krebs,et al.  Zinc bioavailability and homeostasis. , 2010, The American journal of clinical nutrition.

[15]  E. Ho,et al.  Zinc and prostatic cancer , 2009, Current opinion in clinical nutrition and metabolic care.

[16]  J. Palmer,et al.  Vitamin and mineral use and risk of prostate cancer: the case–control surveillance study , 2009, Cancer Causes & Control.

[17]  Sara E. Wagner,et al.  Soil zinc content, groundwater usage, and prostate cancer incidence in South Carolina , 2009, Cancer Causes & Control.

[18]  U. Peters,et al.  Zinc Intake From Supplements and Diet and Prostate Cancer , 2009, Nutrition and cancer.

[19]  E. Fridman,et al.  Clinical assessment of the cancer diagnostic value of prostatic zinc: A comprehensive needle‐biopsy study , 2008, The Prostate.

[20]  Ross J. Harris,et al.  How much of the data published in observational studies of the association between diet and prostate or bladder cancer is usable for meta-analysis? , 2008, American journal of epidemiology.

[21]  Martin Wiseman,et al.  The Second World Cancer Research Fund/American Institute for Cancer Research Expert Report. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective , 2008, Proceedings of the Nutrition Society.

[22]  I. Thompson,et al.  Dietary patterns, supplement use, and the risk of symptomatic benign prostatic hyperplasia: results from the prostate cancer prevention trial. , 2008, American journal of epidemiology.

[23]  C. la Vecchia,et al.  Dietary zinc and prostate cancer risk: a case-control study from Italy. , 2007, European urology.

[24]  R. Kittles,et al.  IGF-1 and IGFBP-3 gene variants influence on serum levels and prostate cancer risk in African-Americans. , 2007, Carcinogenesis.

[25]  R. Franklin,et al.  hZip2 and hZip3 zinc transporters are down regulated in human prostate adenocarcinomatous glands , 2007, Molecular Cancer.

[26]  Amy Subar,et al.  Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. , 2007, Journal of the National Cancer Institute.

[27]  D. Medeiros,et al.  Dietary Reference Intakes: the Essential Guide to Nutrient Requirements edited by JJ Otten, JP Hellwig, and LD Meyers, 2006, 560 pages, hardcover, $44.96. The National Academies Press, Washington, DC. , 2007 .

[28]  R. Franklin,et al.  The clinical relevance of the metabolism of prostate cancer; zinc and tumor suppression: connecting the dots , 2006, Molecular Cancer.

[29]  O. Bagasra,et al.  Zinc and Prostate Cancer: A Critical Scientific, Medical, and Public Interest Issue (United States) , 2005, Cancer Causes & Control.

[30]  O. Bagasra,et al.  hZIP1 zinc uptake transporter down regulation and zinc depletion in prostate cancer , 2005, Molecular Cancer.

[31]  Jiang Li,et al.  Measurement of serum zinc improves prostate cancer detection efficiency in patients with PSA levels between 4 ng/mL and 10 ng/mL. , 2005, Asian journal of andrology.

[32]  P. Galan,et al.  Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial , 2005, International journal of cancer.

[33]  A. Kristal,et al.  Supplement use among cancer survivors in the Vitamins and Lifestyle (VITAL) study cohort. , 2004, Journal of alternative and complementary medicine.

[34]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[35]  O. Bagasra,et al.  Prostate Cancer in African American Men Is Associated With Downregulation of Zinc Transporters , 2003, Applied immunohistochemistry & molecular morphology : AIMM.

[36]  W. Willett,et al.  Zinc supplement use and risk of prostate cancer. , 2003, Journal of the National Cancer Institute.

[37]  E. Platz,et al.  Prediagnostic toenail cadmium and zinc and subsequent prostate cancer risk , 2002, The Prostate.

[38]  T. Leonard,et al.  A Bayesian fixed effects analysis of the Mantel–Haenszel model applied to meta‐analysis , 2002, Statistics in medicine.

[39]  I. Thompson,et al.  Dietary Supplement Use in the Prostate Cancer Prevention Trial: Implications for Prevention Trials , 2001, Nutrition and cancer.

[40]  N. Krebs,et al.  Overview of zinc absorption and excretion in the human gastrointestinal tract. , 2000, The Journal of nutrition.

[41]  M. McDowell,et al.  Zinc intake of the U.S. population: findings from the third National Health and Nutrition Examination Survey, 1988-1994. , 2000, The Journal of nutrition.

[42]  J. Stanford,et al.  Vitamin and mineral supplement use is associated with reduced risk of prostate cancer. , 1999, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[43]  M. Spitz,et al.  Case-control study of diet and prostate cancer in China , 1998, Cancer Causes & Control.

[44]  P. Trumbo,et al.  Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. , 1998, Journal of the American Dietetic Association.

[45]  H. Adami,et al.  Energy, nutrient intake and prostate cancer risk: a population‐based case‐control study in Sweden , 1996, International journal of cancer.

[46]  C W Piccoli,et al.  Staging of prostate cancer: results of Radiology Diagnostic Oncology Group project comparison of three MR imaging techniques. , 1994, Radiology.

[47]  S. Greenland,et al.  Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. , 1992, American journal of epidemiology.

[48]  E W Gunter,et al.  An evaluation of a food frequency questionnaire for assessing dietary intake of specific carotenoids and vitamin E among low-income black women. , 1991, American journal of epidemiology.

[49]  T. French,et al.  Adult dietary intake and prostate cancer risk in Utah: a case-control study with special emphasis on aggressive tumors , 1991, Cancer Causes & Control.

[50]  J. Hankin,et al.  Diet and prostatic cancer: a case-control study in Hawaii. , 1988, American journal of epidemiology.

[51]  G Block,et al.  A data-based approach to diet questionnaire design and testing. , 1986, American journal of epidemiology.

[52]  Nicola Orsini,et al.  Meta-analysis for linear and nonlinear dose-response relations: examples, an evaluation of approximations, and software. , 2012, American journal of epidemiology.

[53]  C. Lawton,et al.  Vitamin E and the Risk of Prostate Cancer: The Selenium and Vitamin E Cancer Prevention Trial (SELECT) , 2012 .

[54]  M. Devonald,et al.  Current opinion in clinical nutrition and metabolic care. , 2008, Current opinion in clinical nutrition and metabolic care.

[55]  Jennifer J. Otten,et al.  DRI, Dietary reference intakes : the essential guide to nutrient requirements , 2006 .

[56]  M. Tan,et al.  Role of zinc in the pathogenesis and treatment of prostate cancer: critical issues to resolve , 2004, Prostate Cancer and Prostatic Diseases.

[57]  D. Bishop,et al.  A case-control study of diet and prostate cancer. , 1997, British Journal of Cancer.

[58]  M. Ilic,et al.  Diet and prostate cancer: a case-control study. , 1997, European journal of cancer.

[59]  G Block,et al.  Validation of a self-administered diet history questionnaire using multiple diet records. , 1990, Journal of clinical epidemiology.

[60]  L. Kaul,et al.  Nutrition and prostate cancer: A case‐control study , 1985, The Prostate.