Quebec Research Program for Prostate Cancer Prevention

Prostate cancer continues to be the most frequent cancer among men in Quebec. Despite a good prognosis, the health and psychological consequences following prostate cancer diagnosis and treatment clearly highlight the need to find ways to prevent this disease. Unlike many other cancers (i.e., lung, breast, melanoma, etc.) for which a number of risk factors have been identified and preventive measures can already be implemented, we are still completely empty-handed when it comes to prostate cancer. All that we know for sure is that prostate cancer risk varies according to age, ancestry and family history. Yet the geographic and temporal distributions of prostate cancers in the population suggest that its etiology involves undefined environmental influences. The wide range of factors that may provide the basis for prevention needs to be explored using large and methodologically-strong studies.

Based on this premise, we initiated back in 2010, the Quebec Research Program for Prostate Cancer Prevention. Funding is based on a partnership between the Cancer Research Society, the Fonds de Recherche du Québec—Santé (FRQS), FRQS-RRSE, and the Ministère de l’Enseignement Supérieur, Recherche, Science et Technologie (formerly the Ministère du Développement économique, de l’Innovation et de l’Exportation du Québec), under the GRePEC funding program. It calls upon the collaboration of 12 established Quebec researchers covering environmental, occupational, infectious, lifecourse, molecular and genetic epidemiology, biostatistics and urology. This is probably the largest study ever to evaluate in such depth the possible environmental causes of prostate cancer.

In brief, the Program has allowed us to build, on an existing research infrastructure, a major research effort including 12 objectives: (1) recruit 1,000 study subjects to bring the overall study sample of the Program to 4,000 subjects, (2) evaluate the presence of 110 chemicals in the subjects’ workplaces, (3) evaluate physical activity levels in workplaces, (4) evaluate dietary intakes, (5) collect information on all residences held by the subjects, (6) evaluate whether genetic factors determine how exposure to the environment relates to prostate cancer, (7) analyze hair and toenail samples as biomarkers of exposure to trace metals, (8) evaluate the determinants of prostate cancer progression, (9) create analytical databases, (10) conduct statistical analyses, (11) train students and research personnel, (12) disseminate findings.

We have now reached the 3.3-year mark into this 5-year research program. All of the objectives are on time and progressing as projected. The Program follows the allocated budget. Other than for the 12 researchers, as many as 35 people have participated to date in this Program. We have trained 13 highly-qualified research personnel, 5 MSc and 4 PhD students, 3 postdoctoral fellows, and 10 BSc interns. We have published or submitted 6 manuscripts, 4 other manuscripts will be submitted shortly, have given 30 presentations and participated in 19 meetings. We are now at the stage of disseminating study findings.

Interesting results include the observation of a higher risk of prostate cancer among men exposed to higher levels of traffic-related pollution. We have also found that use of anticoagulants may have a small protective effect against this cancer. Exposure to sunlight during leisure activities was not found to be a protective factor. We observed no association between the socioeconomic position over the lifetime and prostate cancer risk. Sexual activity was found to be related to cancer risk, whereas men with several female sexual partners over the lifetime had decreased risk of prostate cancer. Also, circumcision appeared to have a protective effect, especially among men of African descent. There are no doubts that with the wealth of information collected in the context of this Program, this collective effort in elucidating risk factors for prostate cancer will last for decades to come.

Collaborators: P. Karakiewicz, E. Franco, J. Siemiatycki, M. Goldberg, M-H. Roy-Gagnon, J. Lavoué, M. Abrahamowicz, A. Aprikian, F. Saad, A. Hsing, A. Chokkalingam, M-C. Rousseau, B. Nicolau

Funding: Société de recherche sur le cancer; Enseignment supérieur, Recherche, Science et Technologie de Québec; Fonds de recherche Santé Québec; RRSE; RioTintoAlcan

Years: 2010-2015

Related Publications:

Circumcision and prostate cancer: a population-based case-control study in Montreal, Canada,
BJU International,

Main Findings: