title: Prediagnostic Body Mass Index Trajectories in Relation to Prostate Cancer Incidence and Mortality in the PLCO Cancer Screening Trial.
abstract: Evidence suggests that obesity in adulthood is associated with increased risk of "clinically significant" prostate cancer. However, studies of body mass index (BMI) across the adult life course and prostate cancer risks remain limited.
  
  
  
  In a prospective cohort of 69 873 men in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we examined associations of prediagnostic BMI across the adult life course with risk of incident prostate cancer and fatal prostate cancer (prostate cancer-specific mortality). At 13 years of follow-up, we identified 7822 incident prostate cancer cases, of which 3078 were aggressive and 255 fatal. BMI trajectories were determined using latent-class trajectory modeling. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  
  BMI at age 20 years, 50 years, and baseline questionnaire (mean age = 63 years) were associated with increased risks of fatal prostate cancer (HRs = 1.27-1.32 per five-unit increase). In five BMI trajectories identified, fatal prostate cancer risk was increased in men who had a normal BMI (HR = 1.95, 95% CI = 1.21 to 3.12) or who were overweight (HR = 2.65, 95% CI = 1.35 to 5.18) at age 20 years and developed obesity by baseline compared with men who maintained a normal BMI. Aggressive and nonaggressive prostate cancer were not associated with BMI, and modest inverse associations were seen for total prostate cancer.
  
  
  
  Our results suggest that BMI trajectories during adulthood that result in obesity lead to an elevated risk of fatal prostate cancer.
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Scott P
authors.initials: SP
authors.lastname: Kelly
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Gabriella
authors.initials: G
authors.lastname: Andreotti
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Naji
authors.initials: N
authors.lastname: Younes
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Sean D
authors.initials: SD
authors.lastname: Cleary
authors.affiliation: Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SPK, BIG, GA, MBC); Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC (SPK, NY, SDC).
authors.forename: Michael B
authors.initials: MB
authors.lastname: Cook
mesh_terms: D000368:Aged; D015992:Body Mass Index; D055088:Early Detection of Cancer / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen