Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study
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Biomed Central
Materia
Adiposity Obesity Height Prostate cancer Cohort study Tumour characteristics High grade
Date
2017Referencia bibliográfica
Pérez-Comago, A.; et al. Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study. BMC Medicine, 15: 115 (2017). [http://hdl.handle.net/10481/49667]
Sponsorship
These analyses were supported by Cancer Research UK (C8221/A19170). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS) PI13/ 00061 (EPIC-Granada) and, PI13/01162 (EPIC-Murcia), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, ISCIII Health Research Funds RD12/0036/0018 (cofounded by FEDER funds/European Regional Development Fund ERDF) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 for EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford) (UK).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 (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). Body mass index
(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 highgrade
prostate cancer) and stage (Pheterogeneity = 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.