In late September, Kenfield, et.al., presented a late breaker at the European Cancer Congress in Amsterdam that associated a healthy lifestyle and diet with a 39-46% decreased risk of lethal prostate cancer (prostate cancer death or metastatic disease).
The United States-based Health Professionals Follow-Up Study (HPFS) followed 45,911 men and the Physicians’ Health Study (PHS) followed 21,227 men from 1986-2012 and 1982-2011 respectively for lifestyle and dietary data. The studies defined men at low risk based upon six lifestyle and dietary factors:
| DEFINITION of LOW-RISK MEN | HPFS | PHS |
| Non-smoking or quit > 10 years | x | x |
| BMI < 30 | x | x |
| Exercise | > 3 hrs/ week vigorous or > 7 hrs brisk walking | > 5 hrs / week vigorous |
| Tomatoes | > 7 / week | > 3 / week |
| Fatty Fish | > 1 / week | > 1/week |
| Processed Red Meat | < 3/ week | < 1 /week |
Two scores were used – a food-only score (0-3) and a total score (0-6). Results were adjusted for age, time period, diabetes, race, and vitamin and vitamin E supplementation.
In the results, men with 5-6 healthy factors compared to those with < 1 had a 39% decreased risk of lethal prostate cancer (HR:0.61; 95% CI:0.42-0.88, P trend = 0.0009) in the HPFS and a 46% decreased risk (HR:0.54; 95% CI:0.30-0.95, P trend = 0.005) in the PHS. Looking at dietary factors only, the decrease was 27% and 48% respectively.
Consider this association in light of another study presented by Boniol which concluded that for every 1,000 men who have a PSA, one death is prevented and 12 additional cases of impotence and three cases of incontinence are caused by unnecessary surgery. In May of this year the American Urological Associated dropped its recommendation that men under the age of 40 consider getting a PSA test.