RESUMO
Background: Diverse environmental exposures, as well as dietary and lifestyle factors, are associated with prostate cancer (PC) etiology; however little is known about joint interactive influences. The aim of this study was to analyse effects of diet combined with arsenic in drinking water and agricultural occupation on PC risk. Methods: A case-control study was conducted in Córdoba, Argentina (period 2008-2015) including 147 cases of PC and 300 controls. All subjects were interviewed about food consumption, socio-demographic and lifestyle characteristics. A sample of drinking water was taken to determine arsenic concentrations. Adherence scores to the Traditional Dietary Pattern were estimated, based on a principal component factor analysis. A two-level logistic regression model was fitted in order to assess effects of the Traditional Pattern, occupation and arsenic exposure on the occurrence of PC (outcome). Family history of PC was considered as a clustering variable. Results: PC risk was greatest in subjects with high adherence to the Traditional Pattern (OR 2.18; 95%IC 1.0974.344). Subjects exposed to arsenic in drinking water above 0.01mg/l who simultaneously performed agricultural activities showed a markedly elevated PC risk (OR 5.07; 95%IC 2.074-12.404). Variance of the random effect of family history of PC was significant. conclusion: Diet, arsenic and occupation in agriculture exert significant effects on PC risk. Further efforts are necessary to analyse risk factors integrally, in order to achieve a better understanding of the complex causal network for PC in this multiple-exposure population.