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Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age : Data from the malmö preventive project

Assel, Melissa J.; Gerdtsson, Axel LU ; Thorek, Daniel L.J.; Carlsson, Sigrid V.; Malm, Johan LU ; Scardino, Peter T.; Vickers, Andrew; Lilja, Hans LU and Ulmert, David LU (2018) In Oncotarget 9(5). p.5778-5785
Abstract

Objectives: To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results: After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods: In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data.... (More)

Objectives: To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results: After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods: In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Conclusions: Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multivariable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
BMI, Obesity, Prostate cancer, PSA, Weight
in
Oncotarget
volume
9
issue
5
pages
8 pages
publisher
Impact Journals, LLC
external identifiers
  • scopus:85040661689
ISSN
1949-2553
DOI
10.18632/oncotarget.22981
language
English
LU publication?
yes
id
3da68227-6703-4e43-b704-ae2c789886b7
date added to LUP
2018-02-26 17:19:49
date last changed
2018-05-29 11:21:50
@article{3da68227-6703-4e43-b704-ae2c789886b7,
  abstract     = {<p>Objectives: To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results: After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods: In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Conclusions: Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multivariable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.</p>},
  author       = {Assel, Melissa J. and Gerdtsson, Axel and Thorek, Daniel L.J. and Carlsson, Sigrid V. and Malm, Johan and Scardino, Peter T. and Vickers, Andrew and Lilja, Hans and Ulmert, David},
  issn         = {1949-2553},
  keyword      = {BMI,Obesity,Prostate cancer,PSA,Weight},
  language     = {eng},
  number       = {5},
  pages        = {5778--5785},
  publisher    = {Impact Journals, LLC},
  series       = {Oncotarget},
  title        = {Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age : Data from the malmö preventive project},
  url          = {http://dx.doi.org/10.18632/oncotarget.22981},
  volume       = {9},
  year         = {2018},
}