Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality

Authors

  • Margaret E. Wright PhD,

    Corresponding author
    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
    • Department of Pathology MC847, University of Illinois at Chicago, 840 South Wood Street, Room 130 CSN, Chicago, IL 60612
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    • The first 2 authors contributed equally to this work.

    • Fax: (312) 996-7586.

  • Shih-Chen Chang PhD,

    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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    • The first 2 authors contributed equally to this work.

  • Arthur Schatzkin MD, DrPH,

    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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  • Demetrius Albanes MD,

    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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  • Victor Kipnis PhD,

    1. Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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  • Traci Mouw MPH,

    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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  • Paul Hurwitz MPH,

    1. Westat, Inc., Rockville, Maryland
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  • Albert Hollenbeck PhD,

    1. AARP, Washington, DC
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  • Michael F. Leitzmann MD, DrPH

    1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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  • This article is a US Government work and, as such, is in the public domain in the United States of America.

  • Cancer incidence data from the Atlanta metropolitan area were collected by the Georgia Center for Cancer Statistics, Department of Epidemiology, Rollins School of Public Health, Emory University; from California by the California Department of Health Services, Cancer Surveillance Section; from the Detroit metropolitan area by the Michigan Cancer Surveillance Program, Community Health Administration, State of Michigan; from Florida by the Florida Cancer Data System under contract to the Department of Health (DOH), and the views expressed herein are solely those of the authors and do not necessarily reflect those of the contractor or DOH; from Louisiana by the Louisiana Tumor Registry, Louisiana State University Medical Center in New Orleans; from New Jersey by the New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey State Department of Health and Senior Services; from North Carolina by the North Carolina Central Cancer Registry; from Pennsylvania by the Division of Health Statistics and Research, Pennsylvania Department of Health, Harrisburg, Pennsylvania, and the Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions.

Abstract

BACKGROUND.

Adiposity has been linked inconsistently with prostate cancer, and few studies have evaluated whether such associations vary by disease aggressiveness.

METHODS.

The authors prospectively examined body mass index (BMI) and adult weight change in relation to prostate cancer incidence and mortality in 287,760 men ages 50 years to 71 years at enrollment (1995–1996) in the National Institutes of Health-AARP Diet and Health Study. At baseline, participants completed questionnaires regarding height, weight, and cancer screening practices, including digital rectal examinations and prostate-specific antigen tests. Cox regression analysis was used to calculate relative risks (RR) and 95% confidence intervals (95% CIs).

RESULTS.

In total, 9986 incident prostate cancers were identified during 5 years of follow-up, and 173 prostate cancer deaths were ascertained during 6 years of follow-up. In multivariate models, higher baseline BMI was associated with significantly reduced total prostate cancer incidence, largely because of the relationship with localized tumors (for men in the highest BMI category [≥40 kg/m2] vs men in the lowest BMI category [<25 kg/m2]: RR, 0.67; 95% CI, 0.50–0.89; P = .0006). Conversely, a significant elevation in prostate cancer mortality was observed at higher BMI levels (BMI <25 kg/m2: RR, 1.0 [referent group]; BMI 25–29.9 kg/m2: RR, 1.25; 95% CI, 0.87–1.80; BMI 30–34.9 kg/m2: RR, 1.46; 95% CI, 0.92–2.33; and BMI ≥35 kg/m2: RR, 2.12; 95% CI, 1.08–4.15; P = .02). Adult weight gain from age 18 years to baseline also was associated positively with fatal prostate cancer (P = .009), but not with incident disease.

CONCLUSIONS.

Although adiposity was not related positively to prostate cancer incidence, higher BMI and adult weight gain increased the risk of dying from prostate cancer. Cancer 2007. Published 2007 by the American Cancer Society.

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