title: Family history of prostate cancer and obesity in relation to high-grade disease and extraprostatic extension in young men with prostate cancer.
abstract: BACKGROUND
  Little is known about predictors of prostate cancer severity in young men. Therefore, we examined whether family history and obesity influence risk of high-grade disease and extraprostatic extension in men < 55-years old.
  
  
  METHODS
  Four hundred ninety-eight men aged < 55 years who had had a radical prostatectomy (1992-1999) by one surgeon were mailed a survey in 2000 to assess family history of PCa and anthropometrics. Body mass index (BMI = kg/m(2)) was calculated as an indicator of obesity. Logistic regression was used to compute odds ratios (OR) for high-grade disease (Gleason score > or = 7) and extraprostatic extension.
  
  
  RESULTS
  Of the 363 respondents, 35.8% had at least one first-degree relative with PCa. Men with a family history were younger at surgery than those without a family history (48.8 vs. 50.1 years, P < 0.001). After controlling for age, cigarette smoking, and race/ethnicity, men with an affected father had a lower risk of high-grade disease compared to those without an affected father (OR = 0.42, 95% CI 0.23-0.76). Risk of high-grade disease increased with increasing BMI, especially in men < 50-years old (P-trend = 0.02). Family history and BMI were not clearly associated with extraprostatic extension.
  
  
  CONCLUSIONS
  After taking into account a younger age at presentation among men with a family history, young men with a family history of PCa were less likely to have high-grade disease. Obesity may be associated with a poorer histology in young men with PCa, especially in men younger than 50 years of age.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: William W
authors.initials: WW
authors.lastname: Roberts
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Walsh
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Platz
mesh_terms: D015992:Body Mass Index; D006306:Health Surveys; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009765:Obesity / Q000235:genetics*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery