Height, body mass index and prostate cancer risk and mortality by way of detection and cancer risk category

Sylvia H.J. Jochems, Pär Stattin, Christel Häggström, Bengt Järvholm, Marju Orho-Melander, Angela M. Wood, Tanja Stocks

Research output: Contribution to journalArticlepeer-review

Abstract

Obesity is a risk factor for advanced, but not localised, prostate cancer (PCa), and for poor prognosis. However, the detection of localised PCa through asymptomatic screening might influence these associations. We investigated height and body mass index (BMI) among 431 902 men in five Swedish cohorts in relation to PCa risk, according to cancer risk category and detection mode, and PCa-specific mortality using Cox regression. Statistical tests were two-sided. Height was positively associated with localised intermediate-risk PCa (HR per 5 cm, 1.03, 95% CI 1.01-1.05), while overweight and obesity were negatively associated with localised low- and intermediate-risk PCa (HRs per 5 kg/m2, 0.86, 95% CI 0.81-0.90, and 0.92, 95% CI 0.88-0.97). However, these associations were partially driven by PCa's detected by asymptomatic screening and, for height, also by symptoms unrelated to PCa. The HR of localised PCa's, per 5 kg/m2, was 0.88, 95% CI 0.83 to 0.92 for screen-detected PCa's and 0.96, 95% CI 0.90 to 1.01 for PCa's detected through lower urinary tract symptoms. BMI was positively associated with PCa-specific mortality in the full population and in case-only analysis of each PCa risk category (HRs per 5 kg/m2, 1.11-1.22, P for heterogeneity =.14). More active health-seeking behaviour among tall and normal-weight men may partially explain their higher risk of localised PCa. The higher PCa-specific mortality among obese men across all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.

Original languageEnglish
Pages (from-to)3328-3338
Number of pages11
JournalInternational Journal of Cancer
Volume147
Issue number12
Early online date2020 Jun 11
DOIs
Publication statusPublished - 2020 Dec 15

Subject classification (UKÄ)

  • Public Health, Global Health, Social Medicine and Epidemiology

Free keywords

  • body mass index
  • body size
  • height
  • observational research
  • prostate cancer

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