title: Obesity and Prostate Cancer.
abstract: Prostate cancer is a complex, heterogeneous disease. Factors related to detection, particularly PSA screening, further increase heterogeneity in the manifestation of the disease. It is thus not possible to provide a simple summary of the relationship between obesity and prostate cancer. Findings on obesity, often defined using body mass index (BMI), and total prostate cancer risk have been mixed; however, obesity is relatively consistently associated with a higher risk of aggressive prostate cancer, with aggressiveness defined in various ways (e.g., advanced stage, fatal, poorer prognosis in men with prostate cancer). Many methodologic issues (e.g., influence of PSA screening, detection bias and treatment) need to be thoroughly considered in both existing and future etiologic and prognostic research. Biological mechanisms supporting the link are under investigation, but may involve insulin and IGF axis, sex steroid hormones and alterations in metabolism. Some promising data suggest that molecular sub-types of prostate cancer may offer insights into etiology, but further study is required. A full evaluation of body fatness and weight change over the life course would not only provide insights to the underlying mechanisms but also allow more effective interventions.
authors.affiliation: Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.|Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Yin
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA. egiovann@hsph.harvard.edu.|Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. egiovann@hsph.harvard.edu.|Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. egiovann@hsph.harvard.edu.
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000273:Adipose Tissue / Q000378:metabolism / Q000503:physiopathology; D050154:Adiposity; D000367:Age Factors; D014408:Biomarkers, Tumor / Q000378:metabolism; D015992:Body Mass Index; D002471:Cell Transformation, Neoplastic / Q000378:metabolism / Q000473:pathology; D015897:Comorbidity; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D056128:Obesity, Abdominal / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor
keywords: Heterogenity; Obesity; Prostate cancer; Prostate-specific antigen screening