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Prostate Cancer

Anthropometric Measures at Multiple Times Throughout Life and Prostate Cancer Diagnosis, Metastasis, and Death

By: Axel Gerdtsson a b , Jessica B. Poon c , Daniel L. Thorek d , Lorelei A. Mucci e , Michael J. Evans f , Peter Scardino g , Per-Anders Abrahamsson a , Peter Nilsson h , Jonas Manjer i , Anders Bjartell a , Johan Malm b , Andrew Vickers f , Stephen J. Freedland j k , Hans Lilja h l m n o and David Ulmert a c

European Urology, Volume 68 Issue 6, December 2015, Pages 1076-1082

Published online: 01 December 2015

Keywords: Metabolic syndrome–associated anthropometrics, Risk factors, Long-term risk predictions, Exposure windows, Prostate cancer

Abstract Full Text Full Text PDF (672 KB) Patient Summary

Abstract

Background

Previous studies of prostate cancer (PCa) risk and anthropometrics (ie, body measurements) were based on single measurements or obtained over limited time spans.

Objective

To study the association between anthropometrics measured at multiple time points in life and their relation to later diagnosis, metastasis, or death from PCa.

Design, setting, and participants

This case-control study includes 27 167 Swedish men enrolled in two population-based projects from 1974 to 1996. PCa diagnosis up to December 31, 2006, disease information, gestation time, and anthropometrics at birth, military conscript testing, and adulthood were collected. A total of 1355 PCa cases were matched with 5271 controls.

Outcome measurements and statistical analysis

Univariate conditional logistic regression was used to determine whether clinical diagnosis, metastasis, or PCa death was associated with low birth weight (weight <2500 g); with small size for gestational age; or with weight, length, or body mass index (BMI) at birth, adolescence (aged 16–22 yr), or early middle age (aged 44–50 yr).

Results and limitations

Apart from weight at adolescence, which was associated with an increased risk of PCa diagnosis (odds ratio [OR] per 5 kg: 1.05; 95% confidence interval [CI], 1.01–1.09; p = 0.026), preadulthood measurements were not associated with any PCa end point. Adulthood parameters were not associated with diagnosis. In contrast, weight and BMI at early middle age were significantly associated with metastasis (OR per 5 kg: 1.13; 95% CI, 1.06–1.20; p < 0.0001, and OR: 1.09; 95% CI, 1.05–1.14; p < 0.0001) and death (OR per 5 kg: 1.11 (95% CI, 1.03–1.19; p = 0.005, and OR: 1.08; 95% CI, 1.03–1.13; p = 0.003), respectively. It remains unclear whether these results apply to men of nonwhite origin, to populations with active PCa screening programs, or to countries without socialized health care.

Conclusions

The analyses of these large data sets demonstrate that significant effects of body characteristics (with links to metabolic syndrome) measured at early middle age are associated with PCa disease severity, metastatic progression, and outcome. Conversely, measurements at birth and adolescence are not associated with PCa prevalence or outcome.

Patient summary

Increased weight and body mass index in adults is associated with a higher risk of prostate cancer metastasis and death.

Take Home Message

Anthropometric factors with links to metabolic syndrome measured at early middle age, as opposed to measurements at birth or adolescence, are associated with prostate cancer disease severity and metastatic progression.

Keywords: Metabolic syndrome–associated anthropometrics, Risk factors, Long-term risk predictions, Exposure windows, Prostate cancer.

Footnotes

a Department of Clinical Sciences (Urology), Lund University, Skåne University Hospital, Malmö, Sweden

b Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, Sweden

c Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

d Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA

e Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

f Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA

g Department of Surgery (Urology), Memorial Sloan-Kettering Cancer Center, New York, NY, USA

h Department of Clinical Sciences (Medicine), Lund University, Skåne University Hospital, Malmö, Sweden

i Department of Clinical Sciences (Surgery), Lund University, Skåne University Hospital, Malmö, Sweden

j Surgery Section, Durham VA Medical Center, Durham, NC, USA

k Department of Surgery (Urology), Cedars Sinai Medical Center, Los Angeles, CA, USA

l Departments of Laboratory Medicine and Medicine (GU-Oncology), Memorial Sloan-Kettering Cancer Center, New York, NY, USA

m Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

n Institute of Biomedical Technology, University of Tampere, Tampere, Finland

o Molecular Pharmacology and Chemistry Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

Corresponding author. Department of Surgery (Urology), Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Tel. +1 347 813 0543.

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