Send to

Choose Destination
Eur Urol Focus. 2015 Aug;1(1):28-38. doi: 10.1016/j.euf.2014.10.002. Epub 2015 May 11.

Smoking and Prostate Cancer: A Systematic Review.

Author information

Department of Urology, Sant'Andrea Hospital, University "La Sapienza", Rome, Italy. Electronic address:
Division of Urology, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, USA.
Department of Urology, The Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio TX, USA.
Section of Urology, Durham VA Medical Center and Division of Urology, Duke Prostate Cancer Centre, Departments of Surgery and Pathology, Duke School of Medicine, Durham, NC, USA.



Cigarette smoking is the leading cause of death from cancer, although the relationship between smoking and prostate cancer (PCa) is controversial.


To evaluate the available evidence of the role of cigarette smoking and PCa development and progression and to discuss possible clinical implications for PCa management.


A PubMed search for relevant articles published between 2004 and September 2014 was performed by combining the following PICO (patient population, intervention, comparison, outcome) terms: male, smoking, prostate, prostate cancer, prevention, diagnosis, treatment, and prognosis. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed.


The association between cigarette smoking and PCa incidence is controversial, particularly in recent series. Current cigarette smoking is associated with an increased risk of PCa death, and the number of cigarettes smoked per day had a dose-response association with PCa mortality. Smokers present a higher risk of biochemical or distant failure after PCa treatment. Several biological mechanisms behind these associations have been proposed, although the molecular mechanisms remain unclear. Further research is required to better understand the role of smoking on PCa development and progression and, particularly, to evaluate the possible effect of smoking cessation on PCa management.


Data from the peer-reviewed literature suggested an association of smoking and aggressive PCa. Although the pathophysiology underlying this association remains unclear, smokers presented higher PCa mortality and worse outcome after treatment. Smoking-cessation counseling should be implemented for patients with PCa, although its effect on PCa progression should be investigated.


We looked at the association between smoking and prostate cancer (PCa). Smokers have a higher risk of PCa mortality and worse outcomes after treatment. Smoking cessation should be encouraged in men with or at risk of having PCa.


Outcome; Prostate; Prostate cancer; Smoking; Treatment


Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center