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Using data from the Health Professionals Follow\u2010Up Study, we re\u2010examined 10 factors (cigarette smoking history, physical activity, BMI, family history of prostate cancer, race, height, total energy consumption, and intakes of calcium, tomato sauce and \u03b1\u2010linolenic acid) using multivariable Cox regression in relation to multiple subcategories for prostate cancer risk. These were factors that we previously found to be predictors of prostate cancer incidence or advanced prostate cancer in this cohort, and that have some support in the literature. In this analysis, only 4 factors had a clear statistically significant association with overall incident prostate cancer: African\u2013American race, positive family history, higher tomato sauce intake (inversely) and \u03b1\u2010linolenic acid intake. In contrast, for fatal prostate cancer, recent smoking history, taller height, higher BMI, family history, and high intakes of total energy, calcium and \u03b1\u2010linolenic acid were associated with a statistically significant increased risk. Higher vigorous physical activity level was associated with lower risk. In relation to these risk factors, advanced stage at diagnosis was a good surrogate for fatal prostate cancer, but high\u2010grade (Gleason \u2265 7 or Gleason \u2265 8) was not. Only for high calcium intake was there a close correspondence for associations among high\u2010grade cancer, advanced and fatal prostate cancer. Tomato sauce (inversely) and \u03b1\u2010linolenic acid (positively) intakes were strong predictors of advanced cancer among those with low\u2010grade cancers at diagnosis. Although the proportion of advanced stage cancers was much lower after PSA screening began, risk factors for advanced stage prostate cancers were similar in the pre\u2010PSA and PSA era. The complexity of the clinical and pathologic manifestations of prostate cancer must be considered in the design and interpretation of studies. \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ijc.22788","type":"journal-article","created":{"date-parts":[[2007,4,20]],"date-time":"2007-04-20T11:53:31Z","timestamp":1177070011000},"page":"1571-1578","source":"Crossref","is-referenced-by-count":426,"title":["Risk factors for prostate cancer incidence and progression in the health professionals follow\u2010up study"],"prefix":"10.1002","volume":"121","author":[{"given":"Edward","family":"Giovannucci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Platz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meir J.","family":"Stampfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C.","family":"Willett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,4,20]]},"reference":[{"key":"e_1_2_6_2_2","series-title":"Cancer incidence in five continents, International agency for research on cancer","author":"Parkin DM","year":"2003"},{"key":"e_1_2_6_3_2","volume-title":"Cancer incidence in five continents, International agency for research on cancer","author":"Parkin DM","year":"1992"},{"key":"e_1_2_6_4_2","first-page":"43","article-title":"Studies of Japanese migrants. 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