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Height, body mass index, and prostate cancer risk and mortality by way of detection and cancer risk category
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden..ORCID iD: 0000-0001-6808-4405
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
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2020 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 147, no 12, p. 3328-3338Article in journal (Refereed) Published
Abstract [en]

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 to 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 to 0.90, and 0.92, 95% CI 0.88 to 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 , 95% CI 1.11 to 1.22, P for heterogeneity = 0.14). 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 accros all PCa risk categories in our study suggests obesity as a potential target to improve the prognosis of obese PCa patients.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020. Vol. 147, no 12, p. 3328-3338
Keywords [en]
body mass index, body size, height, observational research, prostate cancer
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-172173DOI: 10.1002/ijc.33150ISI: 000542848300001PubMedID: 32525555Scopus ID: 2-s2.0-85087142182OAI: oai:DiVA.org:umu-172173DiVA, id: diva2:1441800
Funder
Swedish Research Council, 2017-00650Swedish Research Council, 2015-02332Swedish Research Council, 2018-02825Swedish Cancer Society, 2017/1019Swedish Cancer Society, 2017/475Available from: 2020-06-16 Created: 2020-06-16 Last updated: 2021-06-09Bibliographically approved

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Häggström, ChristelJärvholm, Bengt

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Stattin, PärHäggström, ChristelJärvholm, BengtStocks, Tanja
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Urology and AndrologyDepartment of Biobank ResearchNutritional ResearchSection of Sustainable Health
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