Prostate Cancer Dietary Zinc and Prostate Cancer Risk: A Case-Control Study from Italy Silvano Gallus a, *, Roberto Foschi a , Eva Negri a , Renato Talamini b , Silvia Franceschi c , Maurizio Montella d , Valerio Ramazzotti e , Alessandra Tavani a , Luigino Dal Maso b , Carlo La Vecchia a,f a Department of Epidemiology, Istituto di Ricerche Farmacologiche ‘‘Mario Negri’’, Milan, Italy b Unita ` di Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, Aviano, Italy c International Agency for Research on Cancer, Lyon, France d Istituto Tumori ‘‘Fondazione Pascale,’’ Cappella dei Cangiani, Naples, Italy e Servizio Integrato di Epidemiologia e Sistemi Informativi, Istituto Regina Elena, Rome, Italy f Istituto di Statistica Medica e Biometria, Universita ` degli Studi di Milano, Milan, Italy european urology 52 (2007) 1052–1057 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted January 25, 2007 Published online ahead of print on February 5, 2007 Keywords: Case-control study Diet Prostate cancer Risk factors Zinc Abstract Objectives: Zinc concentration is higher in the prostate than in most other tissues. Since information on the role of zinc on prostate carcinogenesis is controversial, we analysed the issue in a case-control study. Methods: Between 1991 and 2002, we conducted a multicentre hospital- based case-control study on prostate cancer in Italy. Cases included 1294 men with incident, histologically confirmed prostate cancer. Controls included 1451 patients admitted to the same hospitals as cases for a wide spectrum of acute non-neoplastic, non–hormone-related diseases. Zinc intake was computed from a valid and reproducible food frequency questionnaire, with the use of an Italian food composition database. Odds ratios (OR) of dietary intake of zinc and the corresponding 95% confidence intervals (CI) were estimated by unconditional multiple logistic regression models, after allowance for several covariates, including total energy. Results: Compared with the lowest quintile, the OR for the highest quintile was 1.56 (95% CI, 1.07–2.26), with a significant trend in risk ( p = 0.04). The trend in risk was significant for advanced cancers only, the OR being 2.02 (95% CI, 1.14–3.59) for prostate cancers with a high Gleason score. Conclusions: In this large study we found a direct association between high zinc intake and prostate cancer risk, particularly for advanced cancers. Our findings allow one to exclude a favourable effect of zinc on prostate carcinogenesis. # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea, 62, 20157 Milano, Italy. Tel. +39 02 39014 526; Fax: +39 02 33200231. E-mail address: gallus@marionegri.it (S. Gallus). 0302-2838/$ – see back matter # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2007.01.094