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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-07-13

AUTHORS

Aurora Perez-Cornago, Paul N. Appleby, Tobias Pischon, Konstantinos K. Tsilidis, Anne Tjønneland, Anja Olsen, Kim Overvad, Rudolf Kaaks, Tilman Kühn, Heiner Boeing, Annika Steffen, Antonia Trichopoulou, Pagona Lagiou, Maria Kritikou, Vittorio Krogh, Domenico Palli, Carlotta Sacerdote, Rosario Tumino, H. Bas Bueno-de-Mesquita, Antonio Agudo, Nerea Larrañaga, Elena Molina-Portillo, Aurelio Barricarte, Maria-Dolores Chirlaque, J. Ramón Quirós, Pär Stattin, Christel Häggström, Nick Wareham, Kay-Tee Khaw, Julie A. Schmidt, Marc Gunter, Heinz Freisling, Dagfinn Aune, Heather Ward, Elio Riboli, Timothy J. Key, Ruth C. Travis

ABSTRACT

BACKGROUND: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, 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) cohort. 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 7024 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 (P heterogeneity = 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). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 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 (P heterogeneity = 0.01; HR = 0.86, 0.75-0.99 for localised 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. More... »

PAGES

115

Journal

TITLE

BMC Medicine

ISSUE

1

VOLUME

15

Author Affiliations

  • Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF United Kingdom
  • Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
  • Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
  • Danish Cancer Society Research Center, Copenhagen, Denmark
  • Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
  • Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
  • Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
  • WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
  • Department of Epidemiology, Harvard School of Public Health, Boston, USA
  • Hellenic Health Foundation, Athens, Greece
  • Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
  • Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
  • Unit of Cancer Epidemiology, AO Citta’ della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Turin, Italy
  • Cancer Registry and Histopathology Unit, “Civic - M.P. Arezzo” Hospital, Azienda Sanitaria Provinciale, Ragusa, Italy
  • Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
  • CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
  • Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
  • Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
  • Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
  • Public Health Directorate, Asturias, Spain
  • Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
  • Department of Biobank Research, Umeå University, Umeå, Sweden
  • MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
  • University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
  • Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12916-017-0876-7

    DOI

    http://dx.doi.org/10.1186/s12916-017-0876-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1086009451

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/28701188


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    31 schema:description BACKGROUND: The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, 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) cohort. 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 7024 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 (P <sub>heterogeneity</sub> = 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). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P <sub>heterogeneity</sub> = 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 (P <sub>heterogeneity</sub> = 0.01; HR = 0.86, 0.75-0.99 for localised 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.
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