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Height, body mass index and prostate cancer risk and mortality by way of detection and cancer risk category

Jochems, Sylvia H.J. LU ; Stattin, Pär ; Häggström, Christel ; Järvholm, Bengt ; Orho-Melander, Marju LU ; Wood, Angela M. and Stocks, Tanja LU (2020) In International Journal of Cancer 147(12). p.3328-3338
Abstract

Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m2, 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI... (More)

Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m2, 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI 0.88-0.97). However, these associations were partially driven by PCa's detected by asymptomatic screening and, for height, also by symptoms unrelated to PCa. The HR of localised PCa's, per 5 kg/m2, was 0.88, 95% CI 0.83 to 0.92 for screen-detected PCa's and 0.96, 95% CI 0.90 to 1.01 for PCa's detected through lower urinary tract symptoms. BMI was positively associated with PCa-specific mortality in the full population and in case-only analysis of each PCa risk category (HRs per 5 kg/m2, 1.11-1.22, P for heterogeneity =.14). More active health-seeking behaviour among tall and normal-weight men may partially explain their higher risk of localised PCa. The higher PCa-specific mortality among obese men across all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
body mass index, body size, height, observational research, prostate cancer
in
International Journal of Cancer
volume
147
issue
12
pages
11 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85087142182
  • pmid:32525555
ISSN
0020-7136
DOI
10.1002/ijc.33150
language
English
LU publication?
yes
id
80c21673-be26-4842-baed-b3e288d31161
date added to LUP
2020-07-17 09:40:54
date last changed
2024-06-26 19:03:47
@article{80c21673-be26-4842-baed-b3e288d31161,
  abstract     = {{<p>Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m<sup>2</sup>, 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI 0.88-0.97). However, these associations were partially driven by PCa's detected by asymptomatic screening and, for height, also by symptoms unrelated to PCa. The HR of localised PCa's, per 5 kg/m<sup>2</sup>, was 0.88, 95% CI 0.83 to 0.92 for screen-detected PCa's and 0.96, 95% CI 0.90 to 1.01 for PCa's detected through lower urinary tract symptoms. BMI was positively associated with PCa-specific mortality in the full population and in case-only analysis of each PCa risk category (HRs per 5 kg/m<sup>2</sup>, 1.11-1.22, P for heterogeneity =.14). More active health-seeking behaviour among tall and normal-weight men may partially explain their higher risk of localised PCa. The higher PCa-specific mortality among obese men across all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.</p>}},
  author       = {{Jochems, Sylvia H.J. and Stattin, Pär and Häggström, Christel and Järvholm, Bengt and Orho-Melander, Marju and Wood, Angela M. and Stocks, Tanja}},
  issn         = {{0020-7136}},
  keywords     = {{body mass index; body size; height; observational research; prostate cancer}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  pages        = {{3328--3338}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Height, body mass index and prostate cancer risk and mortality by way of detection and cancer risk category}},
  url          = {{http://dx.doi.org/10.1002/ijc.33150}},
  doi          = {{10.1002/ijc.33150}},
  volume       = {{147}},
  year         = {{2020}},
}