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Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study
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2017 (English)In: BMC Medicine, ISSN 1741-7015, E-ISSN 1741-7015, Vol. 15, no 1, article id 115Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

METHODS: Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths.

RESULTS: Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18-2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14-1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79-0.99 for low-intermediate grade and HR = 1.32, 1.01-1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75-0.99 for localised stage and HR = 1.11, 0.92-1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09-1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07-1.92) and fatal prostate cancer (HR = 1.55, 1.23-1.96).

CONCLUSIONS: The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.

Place, publisher, year, edition, pages
2017. Vol. 15, no 1, article id 115
Keyword [en]
Adiposity, Cohort study, Height, High grade, Obesity, Prostate cancer, Tumour characteristics
National Category
Medical and Health Sciences Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-336239DOI: 10.1186/s12916-017-0876-7ISI: 000405316800001PubMedID: 28701188OAI: oai:DiVA.org:uu-336239DiVA, id: diva2:1165431
Funder
Swedish Cancer SocietySwedish Research Council
Available from: 2017-12-13 Created: 2017-12-13 Last updated: 2018-02-08Bibliographically approved

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