Association of obesity with prostate cancer: a case-control study within the population-based PSA testing phase of the ProtecT study.
BACKGROUND
Obesity has been inconsistently linked to prostate cancer, mainly with mortality rather than incidence. Few large-scale studies exist assessing obesity in relation to prostate-specific antigen (PSA)-detected prostate cancer.


METHODS
We used cases and stratum-matched controls from the population-based PSA-testing phase of the Prostate testing for cancer and Treatment study to examine the hypothesis that obesity as measured by body mass index (BMI), waist circumference and waist-to-hip ratio (WHR) is associated with increased prostate cancer risk, and with higher tumour stage and grade. In all, 2167 eligible cases and 11 638 randomly selected eligible controls with PSA values were recruited between 2001 and 2008. A maximum of 960 cases and 4156 controls had measurement data, and also complete data on age and family history, and were included in the final analysis. BMI was categorised as <25.0, 25.0-29.9, ≥ 30.0 in kg m(-2).


RESULTS
Following adjustment for age and family history of prostate cancer, we found little evidence that BMI was associated with total prostate cancer (odds ratio (OR): 0.83, 95% confidence interval (CI): 0.67, 1.03; highest vs lowest tertile; P-trend 0.1). A weak inverse association was evident for low-grade (OR: 0.76, 95% CI: 0.59, 0.97; highest vs lowest tertile; P-trend 0.045) prostate cancer. We found no association of either waist circumference (OR: 0.94, 95% CI: 0.80, 1.12; highest vs lowest tertile) or waist-to-hip ratio (WHR; OR: 0.93, 95% CI: 0.77, 1.11; highest vs lowest tertile) with total prostate cancer, and in analyses stratified by disease stage (all P-trend>0.35) or grade (all P-trend>0.16).


CONCLUSIONS
General adiposity, as measured by BMI, was associated with a decreased risk of low-grade PSA-detected prostate cancer. However, effects were small and the confidence intervals had limits very close to one. Abdominal obesity (as measured by WHR/waist circumference) was not associated with PSA-detected prostate cancer.
Department of Oncology, University of Cambridge, Addenbrooke's Hospital, Box 279 (S4), Cambridge CB2 0QQ, UK.
P
P
Dimitropoulou
R M
RM
Martin
E L
EL
Turner
J A
JA
Lane
R
R
Gilbert
M
M
Davis
J L
JL
Donovan
F C
FC
Hamdy
D E
DE
Neal
D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
D017430:Prostate-Specific Antigen
Epidemiol Rev. 2001;23(1):126-31
11588836
Cancer Causes Control. 2006 Feb;17(1):5-9
16411047
Aktuelle Urol. 2010 May;41(3):178-83
20446247
Metabolism. 1995 Oct;44(10 Suppl 4):37-44
7476310
Am J Epidemiol. 2000 Mar 15;151(6):541-9
10733035
Int J Cancer. 1994 May 1;57(3):313-7
8168989
Cancer Epidemiol Biomarkers Prev. 2007 Jan;16(1):70-6
17179487
Epidemiol Rev. 1991;13:200-27
1765112
Cancer Epidemiol Biomarkers Prev. 1997 Aug;6(8):557-63
9264267
J Clin Oncol. 2004 Feb 1;22(3):439-45
14691120
Arch Intern Med. 1998 Sep 28;158(17):1855-67
9759681
N Engl J Med. 2003 Apr 24;348(17):1625-38
12711737
Cancer Prev Res (Phila). 2010 Mar;3(3):259-62
20179295
J Natl Cancer Inst. 1995 May 3;87(9):652-61
7752270
Urology. 2004 Feb;63(2):253-8
14972466
Cancer. 1989 Aug 1;64(3):598-604
2743254
Am J Epidemiol. 1988 May;127(5):999-1012
3358418
J Endocrinol. 1997 Nov;155(2):191-2
9415044
BMJ. 2002 Oct 5;325(7367):766-70
12364308
Cancer Causes Control. 2006 Oct;17(8):989-1003
16933050
Cancer Epidemiol Biomarkers Prev. 2009 Mar;18(3):748-51
19258472
J Urol. 1996 Mar;155(3):969-74
8583620
J Natl Cancer Inst. 1997 Mar 5;89(5):385-9
9060961
Prostate. 2009 Apr 1;69(5):520-7
19107851
Br J Cancer. 2003 Oct 6;89(7):1237-42
14520453
Prostate. 2000 May 1;43(2):136-43
10754529
Prostate Cancer Prostatic Dis. 2006;9(1):19-24
16344847
J Clin Endocrinol Metab. 1994 Nov;79(5):1310-6
7962322
Cancer. 2007 Feb 15;109(4):675-84
17211863
Int J Cancer. 2007 Aug 15;121(4):791-5
17455251
Am J Epidemiol. 1984 Aug;120(2):244-50
6465122
Cancer Causes Control. 1999 Aug;10(4):269-75
10482485
Urology. 2005 Jul;66(1):108-13
15992911
J Natl Cancer Inst. 2003 Aug 20;95(16):1240-4
12928350
J Natl Cancer Inst. 2002 Jul 17;94(14):1099-106
12122101
Prostate. 2002 Aug 1;52(3):213-35
12111697
Cancer Epidemiol Biomarkers Prev. 2001 Apr;10(4):345-53
11319175
J Urol. 2003 May;169(5):1670-5
12686805
Cancer Epidemiol Biomarkers Prev. 2005 May;14(5):1262-9
15894683
J Urol. 2003 Apr;169(4):1308-11
12629349
Cancer Epidemiol Biomarkers Prev. 2000 Dec;9(12):1335-41
11142419
Ann Epidemiol. 2000 Aug;10(6):361-9
10964002
Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1977-83
17035408
Cancer Causes Control. 1996 Jan;7(1):83-44
8850437
Cancer Epidemiol Biomarkers Prev. 2003 Dec;12(12):1417-21
14693731
Cancer Causes Control. 2001 Feb;12(2):187-93
11246848
Cancer. 2005 Mar 1;103(5):1092-5
15668913
Cancer Epidemiol Biomarkers Prev. 2008 Sep;17(9):2325-36
18768501
J Natl Cancer Inst. 2010 Apr 21;102(8):519-21
20388875
Am J Epidemiol. 2007 Jun 1;165(11):1271-9
17395597
J Clin Oncol. 2004 Feb 1;22(3):446-53
14691122
Obes Res. 2004 Dec;12(12):1930-5
15687393
J Natl Cancer Inst. 2000 Sep 20;92(18):1472-89
10995803
Cancer Epidemiol Biomarkers Prev. 2007 Jan;16(1):63-9
17179486
Int J Cancer. 2004 Jun 10;110(2):278-83
15069694
Br J Cancer. 2004 Jun 1;90(11):2176-80
15150581
Br J Cancer. 2009 Jun 2;100(11):1799-805
19436298
J Chronic Dis. 1979;32(8):563-76
468958
Prostate. 2003 May 1;55(2):140-6
12661039
Metabolism. 1991 Jan;40(1):101-4
1984562
Cancer Res. 1984 May;44(5):1998-2010
6370422
Int J Cancer. 2003 Sep 10;106(4):594-9
12845658
Int J Cancer. 1997 Nov 27;73(5):634-8
9398038