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Journal article

Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study

Abstract:

Background

The relationships between body size and prostate cancer risk, and in particular risk by tumour characteristics, are not clear because most studies have not differentiated between tumours that are high grade and those that are advanced stage, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Methods

Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up there were 7,024 incident prostate cancers and 934 prostate cancer deaths.

Results

Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (Pheterogeneity=0.002), with a positive association with risk for high grade, but not low-intermediate grade, disease (HR for high grade disease tallest versus shortest fifth of height 1.54, 95% CI 1.18-2.03). Greater height was also associated with a higher risk for prostate cancer death (HR=1.43, 1.14-1.80). BMI was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (Pheterogeneity=0.01; HR=0.89, 0.79-0.99 for low-intermediate grade and HR=1.32, 1.01-1.72 for high grade prostate cancer) and stage (Pheterogeneity=0.01; HR=0.86, 0.75-0.99 for localized stage and HR=1.11, 0.92-1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR=1.35, 1.09-1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high grade (HR=1.43, 1.07-1.92) and fatal prostate cancer (HR=1.55, 1.23-1.96).

Conclusions

The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high grade prostate cancer and prostate cancer death.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12916-017-0876-7

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Cancer Epidemiology Unit
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Cancer Epidemiology Unit
Role:
Author



Publisher:
BioMed Central
Journal:
BMC Medicine More from this journal
Volume:
15
Pages:
115
Publication date:
2017-07-01
Acceptance date:
2017-05-16
DOI:
EISSN:
1741-7015


Keywords:
Pubs id:
pubs:695483
UUID:
uuid:05972935-882e-45bf-b5fb-f8ff0a799a53
Local pid:
pubs:695483
Deposit date:
2017-05-16

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