title: Is there a role for body mass index in the assessment of prostate cancer risk on biopsy?
abstract: OBJECTIVE
  We examine the role of body mass index in the assessment of prostate cancer risk.
  
  
  METHODS
  A total of 3,258 participants who underwent biopsy (including 1,902 men with a diagnosis of prostate cancer) were identified from the Selenium and Vitamin E Cancer Prevention Trial. The associations of body mass index with prostate cancer and high grade prostate cancer were examined using logistic regression, adjusting for age, race, body mass index adjusted prostate specific antigen, digital rectal examination, family history of prostate cancer, biopsy history, prostate specific antigen velocity, and time between study entry and the last biopsy. The prediction models were compared with our previously developed body mass index adjusted Prostate Cancer Prevention Trial prostate cancer risk calculator.
  
  
  RESULTS
  Of the study subjects 49.1% were overweight and 29.3% were obese. After adjustment, among men without a known family history of prostate cancer, increased body mass index was not associated with a higher risk of prostate cancer (per one-unit increase in logBMI OR 0.83, p=0.54) but was significantly associated with a higher risk of high grade prostate cancer (ie Gleason score 7 or greater prostate cancer) (OR 2.31, p=0.03). For men with a known family history of prostate cancer the risks of prostate cancer and high grade prostate cancer increased rapidly as body mass index increased (prostate cancer OR 3.73, p=0.02; high grade prostate cancer OR 7.95, p=0.002). The previously developed risk calculator generally underestimated the risks of prostate cancer and high grade prostate cancer.
  
  
  CONCLUSIONS
  Body mass index provided independently predictive information regarding the risks of prostate cancer and high grade prostate cancer after adjusting for other risk factors. Body mass index, especially in men with a known family history of prostate cancer, should be considered for inclusion in any clinical assessment of prostate cancer risk and recommendations regarding prostate biopsy.
authors.affiliation: Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Cancer Therapy & Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Center for Research to Advance Community Health, San Antonio, Texas; School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas. Electronic address: liangy@uthscsa.edu.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Norma S
authors.initials: NS
authors.lastname: Ketchum
authors.affiliation: SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Phyllis J
authors.initials: PJ
authors.lastname: Goodman
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
authors.affiliation: Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Cancer Therapy & Research Center, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
mesh_terms: D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D017430:Prostate-Specific Antigen
keywords: body mass index; neoplasm grading; prostate-specific antigen; prostatic neoplasms; risk factors
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