title: Association of body mass index and prostate cancer mortality.
abstract: OBJECTIVE
  Inconsistent evidence exists on whether obesity is associated with an increased risk of prostate cancer death post-radical prostatectomy. We examined data from three large health plans to evaluate if an increased body mass index (BMI) at prostate cancer diagnosis is related to prostate cancer mortality
  
  
  METHODS
  This population-based case-control study included 751 men with prostate cancer who underwent radical prostatectomy. Cases were men who died due to prostate cancer (N=323) and matched controls (N=428). We used multivariable logistic regression models to assess the association between BMI at diagnosis and prostate cancer mortality, adjusted for Gleason score, PSA, tumour characteristics, and matching factors.
  
  
  RESULTS
  Study subjects were classified into the following BMI (kg/m2) categories: healthy (18.5-24.9), overweight (25-29.9) and obese (≥30). Nearly 43% of the participants had a BMI ≥25 at diagnosis. A higher fraction of cases (30%) were obese compared to controls (22%). Overall, obese men had more than a 50% increase in prostate cancer mortality (adjusted odds ratio=1.50 [95% CI, 1.03-2.19]) when compared to men with healthy BMI. After stratifying by Gleason score, the odds of mortality generally rose with increasing BMI. The strongest effect was observed in the Gleason score 8+ category (2.37, 95% CI: 1.11-5.09). These associations persisted after adjusting for PSA at diagnosis and other tumour characteristics.
  
  
  CONCLUSIONS
  These results suggest that BMI at diagnosis is strongly correlated with prostate cancer mortality, and that men with aggressive disease have a markedly greater odds of death if they are overweight or obese.
authors.affiliation: Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States. Electronic address: Reina.Haque@kp.org.
authors.forename: Reina
authors.initials: R
authors.lastname: Haque
authors.affiliation: Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States.
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.affiliation: Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Wallner
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Richert-Boe
authors.affiliation: Georgetown University, Department of Pathology, Washington, DC, United States.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Kallakury
authors.affiliation: Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.
authors.forename: Renyi
authors.initials: R
authors.lastname: Wang
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States.
authors.forename: Sheila
authors.initials: S
authors.lastname: Weinmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009765:Obesity / Q000150:complications / Q000401:mortality*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000150:complications / Q000401:mortality*; D012307:Risk Factors
keywords: BMI; Case–control; Population sciences; Prostate cancer; Survival
references.citation: Urology. 1999 Nov;54(5):884-90
references.pmid: 10565752
references.citation: JAMA. 2010 Jan 20;303(3):235-41
references.pmid: 20071471
references.citation: Prostate Cancer Prostatic Dis. 2009;12(3):259-63
references.pmid: 19581922
references.citation: Lancet Oncol. 2010 Aug;11(8):741-52
references.pmid: 20594911
references.citation: Lancet. 2008 Feb 16;371(9612):569-78
references.pmid: 18280327
references.citation: Nat Rev Cancer. 2004 Aug;4(8):579-91
references.pmid: 15286738
references.citation: J Natl Cancer Inst. 2008 Aug 20;100(16):1144-54
references.pmid: 18695132
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Oct;15(10):1977-83
references.pmid: 17035408
references.citation: Cancer Epidemiol Biomarkers Prev. 2003 Dec;12(12):1417-21
references.pmid: 14693731
references.citation: Nat Rev Cancer. 2011 Nov 24;11(12):886-95
references.pmid: 22113164
references.citation: Biometrics. 1976 Sep;32(3):599-606
references.pmid: 963173
references.citation: JAMA. 2005 Jul 27;294(4):433-9
references.pmid: 16046649
references.citation: IARC Sci Publ. 1980;(32):5-338
references.pmid: 7216345
references.citation: Prostate. 2001 Apr;47(1):52-8
references.pmid: 11304729
references.citation: Biometrics. 1992 Jun;48(2):397-409
references.pmid: 1637969
references.citation: Cancer Causes Control. 2006 Oct;17(8):989-1003
references.pmid: 16933050
references.citation: Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):501-8
references.pmid: 21242331
references.citation: Cancer. 2007 Mar 15;109(6):1192-202
references.pmid: 17311344
references.citation: J Clin Oncol. 2004 Feb 1;22(3):439-45
references.pmid: 14691120
references.citation: Int J Cancer. 2009 May 15;124(10):2416-29
references.pmid: 19142965
references.citation: Cancer Epidemiol Biomarkers Prev. 2001 Apr;10(4):345-53
references.pmid: 11319175
references.citation: J Urol. 2003 May;169(5):1670-5
references.pmid: 12686805
references.citation: Cancer Prev Res (Phila). 2011 Apr;4(4):486-501
references.pmid: 21233290
references.citation: Cancer Res. 2012 Jan 15;72(2):503-15
references.pmid: 22106399
references.citation: J Clin Oncol. 2004 Feb 1;22(3):446-53
references.pmid: 14691122
references.citation: J Urol. 2006 Oct;176(4 Pt 1):1404-8
references.pmid: 16952644
references.citation: Urology. 2005 Nov;66(5):1060-5
references.pmid: 16286124
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Jan;16(1):63-9
references.pmid: 17179486