PURPOSE: To examine the role of body mass index (BMI) in assessment of prostate cancer (PCa) risk.
MATERIALS AND METHODS: 3,258 participants who underwent biopsy (including 1,902 men with a diagnosis of PCa) were identified from the Selenium and Vitamin E Cancer Prevention Trial. The associations of BMI with PCa and high-grade PCa (HGPCa) were examined using logistic regression, adjusting for age, race, BMI-adjusted prostate-specific antigen, digital rectal exam, family history of PCa, previous biopsy history, PSA velocity and time between study entry and the last biopsy. The prediction models were compared with our previously-developed BMI-adjusted Prostate Cancer Prevention Trial prostate cancer Risk Calculator (bmiPCPTRC).
RESULTS: Of the study subjects, 49.1% were overweight and 29.3% were obese. After adjustment, among men without a known family history of PCa, increased BMI was not associated with higher risk of PCa (per one-unit increase in logBMI: OR=0.83, p=0.54) but was significantly associated with higher risk of HGPCa (i.e., Gleason score ≥7 prostate cancer) (OR=2.31, p=0.03). For men with a known family history of PCa, the risks of PCa and HGPCa increased rapidly as BMI increased (PCa: OR=3.73, p=0.02; HGPCa: OR=7.95, p=0.002). The bmiPCPTRC generally underestimated the risks of PCa and HGPCa.
CONCLUSIONS: BMI provided independently predictive information regarding risks of PCa and HGPCa, after adjusting for other risk factors. BMI, especially among men with a known family history of PCa, should be considered for inclusion in any clinical assessment of PCa risk and recommendations regarding prostate biopsy.
Written by:
Liang Y, Ketchum NS, Goodman PJ, Klein EA, Thompson IM Jr. Are you the author?
Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX; Department of Urology, UTHSCSA, San Antonio, TX; School of Public Health, University of Texas Health Science Center at Houston, Houston, TX; Cancer Therapy & Research Center, UTHSCSA, San Antonio, TX; Center for Research to Advance Community Health, San Antonio, TX; SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA. 4Cleveland Clinic Foundation, Cleveland, OH.
Reference: J Urol. 2014 Apr 17. pii: S0022-5347(14)03343-6.
doi: 10.1016/j.juro.2014.04.015
PubMed Abstract
PMID: 24747090
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