Skip to main content

Advertisement

SpringerLink
Log in

Prostate volume modifies the association between obesity and prostate cancer or high-grade prostatic intraepithelial neoplasia

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

The relationship between obesity and prostate cancer remains unclear. We investigated the effect of prostate volume on the obesity and prostate cancer association. With a multi-centered, rapid-recruitment protocol, weight and body size measurements were collected prior to diagnosis, and medical charts were reviewed for pathology results (n = 420 controls, 119 high-grade prostatic intraepithelial neoplasia (PIN) cases, and 286 cancer cases (41% Gleason > 6). In multivariable logistic regression models adjusting for age, PSA levels and history, DRE results, and number of cores at biopsy, the association between BMI and cancer was restricted to men with a smaller prostate volume (volume < 40 cm3: ORBMI ≥ 30 = 2.17 (1.09, 4.32), p trend = 0.02; volume ≥ 40 cm3: ORBMI ≥ 30 = 0.77 (0.34, 1.77), p trend = 0.17; p interaction = 0.03). Similarly, the WHR and PIN association was significantly modified by prostate volume (volume < 40 cm3: OR(WHR: Tertile 3 vs. T1) = 3.76 (1.54, 9.21) (p trend < 0.01); volume ≥ 40 m3: OR(WHR: T3 vs. T1) = 0.63 (0.32, 1.23) (p trend = 0.17); p interaction < 0.01). In conclusion, prostate volume acts as a modifier, and BMI and WHR are significantly associated with prostate cancer or PIN, respectively, in the absence of biopsy sampling error derived from obesity-related prostate enlargement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

BMI:

Body mass index

WST:

Waist circumference

WHR:

Waist-to-hip ratio

PIN:

High-grade prostatic intraepithelial neoplasia

OR:

Odds ratio

CI:

Confidence interval

References

  1. Nilsen TIL, Vatten LJ (1999) Anthropometry and prostate cancer risk: a prospective study of 22,248 Norwegian men. Cancer Causes Control 10:269–275

    Article  PubMed  CAS  Google Scholar 

  2. Schuurman AG, Goldbohm RA, Dorant E, van den Brandt PA (2000) Anthropometry in relation to prostate cancer risk in the Netherlands Cohort Study. Am J Epidemiol 151:541–549

    PubMed  CAS  Google Scholar 

  3. Hubbard JS, Rohrmann S, Landis PK, et al (2004) Association of prostate cancer risk with insulin, glucose, and anthropometry in the Baltimore longitudinal study of aging. Urology 63:253–258

    Article  PubMed  Google Scholar 

  4. Mills PK, Beeson L, Phillips RL, Fraser GE (1989) Cohort study of diet, lifestyle, and prostate cancer in Adventist men. Cancer 64:598–604

    Article  PubMed  CAS  Google Scholar 

  5. LeMarchand L, Kolonel LN, Wilkins LR, Myers BC, Hirohata T (1994) Animal fat consumption and prostate cancer: a prospective study in Hawaii. Epidemiology 5:276–282

    Article  CAS  Google Scholar 

  6. Whittemore AS, Paffenbarger RS, Anderson K, Lee JE (1985) Early precursors of site-specific cancers in college men and women. JNCI 74:43–51

    PubMed  CAS  Google Scholar 

  7. Severson RK, Grove JS, Nomura A, Stemmermann GN (1988) Body mass and prostatic cancer: a prospective study. Br Med J 297:713–715

    Article  CAS  Google Scholar 

  8. Giovannucci E, Rimm EB, Liu Y et al (2003) Body mass index and risk of prostate cancer in U.S. health professionals. JNCI Cancer Spectrum 95:1240–4

    Google Scholar 

  9. Andersson S-O, Wolk A, Bergstrom R et al (1997) Body size and prostate cancer: a 20-year follow-up study among 135006 Swedish construction workers. JNCI 89:385–389

    Article  PubMed  CAS  Google Scholar 

  10. Gronberg H, Damber L, Damber J-E (1996) Total food consumption and body mass index in relation to prostate cancer risk: a case-control study in Sweden with prospectively collected exposure data. J Urol 155:969–974

    Article  PubMed  CAS  Google Scholar 

  11. Engeland A, Tretli S, Bjorge T (2005) Height, body mass index, and prostate cancer: a follow-up of 950,000 Norwegian men. Br J Cancer 69:1237–1242

    Google Scholar 

  12. Thune I, Lund E (1994) Physical activity and the risk of prostate and testicular cancer: a cohort study of 53,000 Norweigian men. Cancer Causes Control 5:549–556

    Article  PubMed  CAS  Google Scholar 

  13. Aziz NM, Hartman T, Barrett M (2000) Weight and prostate cancer in the Alpha-Tocopherol Beta-Carotene Cancer Prevention (ATBC) Trial. Am Soc Clin Oncol Abst. # 647

  14. Rodriguez C, Freedland SJ, Deka A et al (2006) Body mass index, weight change, and risk of prostate cancer in the cancer prevention study II nutrition cohort. Cancer Epidemiol Biomarkers Prev 16(1):63–69

    Article  PubMed  Google Scholar 

  15. Bradbury BD, Wilk JB, Kaye JA (2005) Obesity and the risk of prostate cancer (United States). Cancer Causes Control 16:637–641

    Article  PubMed  Google Scholar 

  16. Porter MP, Stanford JL (2005) Obesity and the risk of prostate cancer. The Prostate 62:316–321

    Article  PubMed  Google Scholar 

  17. von Hafe P, Pina F, Perez A, Tavares M, Barros H (2004) Visceral fat accumulation as a risk factor for prostate cancer. Obes Res 12:1930–1935

    Google Scholar 

  18. Hsing AW, Deng J, Sesterhenn IA et al (2000) Body size and prostate cancer: a population-based case-control study in China. Cancer Epidemiol Biomarkers Prev 9:1335–1341

    PubMed  CAS  Google Scholar 

  19. Gong Z, Neuhouser ML, Goodman PJ et al (2006) Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 15:1977–1983

    Article  PubMed  Google Scholar 

  20. Tande AJ, Platz EA, Folsom AR (2006) The metabolic syndrome is associated with reduced risk of prostate cancer. Am J Epidemiol 164:1094–1102

    Article  PubMed  Google Scholar 

  21. Sakr WA, Grignon DJ, Crissman JD et al (1994) High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20–69: an autopsy study of 249 cases. In Vivo 8:439–444

    PubMed  CAS  Google Scholar 

  22. Fontaine KR, Heo M, Allison DB (2005) Obesity and prostate cancer screening in the USA. Public Health 119:694–698

    Article  PubMed  CAS  Google Scholar 

  23. Fowke JH, Signorello LB, Underwood W, Ukoli FA, Blot WJ (2006) Obesity and prostate cancer screening among African-American and Caucasian men. Prostate 66:1371–1380

    Article  PubMed  Google Scholar 

  24. Baillargeon J, Pollock BH, Kristal AR et al (2005) The association of body mass index and prostate-specific antigen in a population-based study. Cancer 103:1092–1095

    Article  PubMed  Google Scholar 

  25. Kristal AR, Chi C, Tangen C, Goodman PJ, Etzioni R, Thompson IM (2005) Associations of demographic and lifestyle characteristics with prostate-specific antigen (PSA) concentration and rate of PSA increase. Cancer 106:320–328

    Article  Google Scholar 

  26. Fowke JH, Signorello LB, Chang SS et al (2006) Effects of obesity and height on PSA and percent free PSA levels among African-American and Caucasian Men. Cancer 107:2361–2367

    Article  PubMed  CAS  Google Scholar 

  27. Soygur T, Kupeli B, Aydos K, Kupeli S, Arikan N, Muftuoglu YZ (1996) Effect of obesity on prostatic hyperplasia: its relation to sex steroid levels. Int Urol Nephrol 28:55–59

    Article  PubMed  CAS  Google Scholar 

  28. Sarma AV, Jaffe CA, Schottenfeld D et al (2002) Insulin-like growth factor-1, insulin-like growth factor binding protein-3, and body mass index: clinical correlates of prostate volume among Black men. Urology 59:362–367

    Article  PubMed  Google Scholar 

  29. Parsons JK, Carter HB, Partin AW et al (2006) Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab 91:2562–2568

    Article  PubMed  CAS  Google Scholar 

  30. Freedland SJ, Platz EA, Presti JC Jr et al (2006) Obesity, serum prostate specific antigen and prostate size: implications for prostate cancer detection. J Urol 175:500–504

    Article  PubMed  Google Scholar 

  31. Hammarsten J, Hogstedt B, Holthuis N, Mellstrom D (1998) Components of the metabolic syndrome—risk factors for the development of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 1:157–162

    Article  PubMed  Google Scholar 

  32. Dahle SE, Chokkalingam AP, Gao YT, Deng J, Stanczyk FZ, Hsing AW (2002) Body size and serum levels of insulin and leptin in relation to the risk of benign prostatic hyperplasia. J Urol 168:599–604

    Article  PubMed  CAS  Google Scholar 

  33. Presti JC, Lee U, Brooks JD, Terris MK (2004) Lower body mass index is associated with a higher prostate cancer detection rate and less favorable pathological features in a biopsy population. J Urol 171:2199–2202

    Article  PubMed  Google Scholar 

  34. Kulkarni GS, Al-Azab R, Lockwood G et al (2006) Evidence for a biopsy derived grade artifact among larger prostate glands. J Urol 175:505–509

    Article  PubMed  Google Scholar 

  35. Freedland SJ, Terris MK, Platz EA, Presti J (2005) Body mass index as a predictor of prostate cancer: Development versus detection on biopsy. Urology 66:108–113

    Article  PubMed  Google Scholar 

  36. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of finasteride on the development of prostate cancer. N Engl J Med 349:213–222

    Article  Google Scholar 

  37. Epstein JI, Herawi M (2006) Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol 175:820–834

    Article  PubMed  Google Scholar 

  38. Bostwick DG, Foster CS (1999) Predictive factors in prostate cancer: current concepts from the 1999 college of American Pathologists Conference on solid tumor prognostic factors and the 1999 World Health Organization Second Internaitonal Consultation of prostate cancer. Semin Oncol 17:222–272

    CAS  Google Scholar 

  39. Bostwick DG (1999) Prostatic intraepithelial neoplasia is a risk factor for cancer. Semin Oncol 17:187–198

    CAS  Google Scholar 

  40. Davidson D, Bostwick DG, Qian J et al (1995) Prostatic intraepithelial neoplasia is a risk factor for adenocarcinoma: predictive accuracy in needle biopsies. J Urol 154:1295–1299

    Article  PubMed  CAS  Google Scholar 

  41. Häggman MJ, Macoska JA, Wojno KJ, Oesterling JE (1997) The relationship between prostatic intraepithelial neoplasia and prostate cancer: critical issues. J Urol 158:12–22

    Article  PubMed  Google Scholar 

  42. Nelson WG, DeMarzo AM, Isaacs WB (2003) Prostate cancer. N Engl J Med 349:366–381

    Article  PubMed  CAS  Google Scholar 

  43. Tuma RS (2006) Split prostate cancer four ways, Willett Says. JNCI Cancer Spectrum 98:959–960

    Article  Google Scholar 

  44. Rohrmann S, Smit E, Giovannucci E, Platz EA (2005) Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III). Int J Obes Relat Metab Disord 29:310–316

    Article  CAS  Google Scholar 

  45. Giovannucci E, Rimm EB, Chute C et al (1994) Obesity and benign prostatic hyperplasia. Am J Epidemiol 140:989–1002

    PubMed  CAS  Google Scholar 

  46. Cottam DR, Mattar SG, Barinas-Mitchell E et al (2004) The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obes Surg 14:589–600

    Article  PubMed  Google Scholar 

  47. Wannamethee SG, Shaper AG, Morris RW, Whincup PH (2005) Measures of adiposity in the identification of metabolic abnormalities in elderly men. Am J Clin Nutr 81:1313–1321

    PubMed  CAS  Google Scholar 

  48. National Institutes of Health (2006) Determination of degree of abdominal obesity. http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4112.htm

  49. Clement K, Viguerie N, Poitou C et al (2004) Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J 18:1657–1659

    Article  PubMed  CAS  Google Scholar 

  50. Thompson IM, Pauler DK, Goodman PJ et al (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level ≤4.0 ng per milliliter. N Engl J Med 350:2239–2246

    Article  PubMed  CAS  Google Scholar 

  51. Gann PH, Hennekens CH, Longcope C, Verhoek-Oftedahl W, Grodstein F, Stampfer MJ (1995) A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. Prostate 26:40–49

    Article  PubMed  CAS  Google Scholar 

  52. Platz EA, Leitzmann MF, Rifai N et al (2005) Sex steroid hormones and the androgen receptor gene CAG repeat and subsequent risk of prostate cancer in the prostate-specific antigen era. Cancer Epidemiol Biomarkers Prev 14:1262–1269

    Article  PubMed  CAS  Google Scholar 

  53. Platz EA, De Marzo AM, Giovannucci E (2004) Prostate cancer association studies: pitfalls and solutions to cancer misclassification in the PSA era. J Cell Biochem 91:553–571

    Article  PubMed  CAS  Google Scholar 

  54. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291:2847–2850

    Article  PubMed  CAS  Google Scholar 

  55. Ford ES, Mokdad AH, Giles WH (2003) Trends in waist circumference among U.S. adults. Obes Res 11:1223–1231

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Funds were been provided by the NIH CA98348, DAMD17-02-1-0139, and M01 RR00095 to the Vanderbilt General Clinical Research Center.

Author information

Authors and Affiliations

  1. Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, 1215 21St Ave. South, Nashville, TN, 37232-8300, USA

    Jay H. Fowke & Saundra S. Motley

  2. Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Michael S. Cookson, Raoul S. Concepcion, Charles W. Eckstein, Sam S. Chang & Joseph A. Smith Jr

  3. Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA

    Marcia Wills

  4. Urology Associates P.C., Nashville, TN, USA

    Raoul S. Concepcion & Charles W. Eckstein

Authors
  1. Jay H. Fowke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Saundra S. Motley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcia Wills
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael S. Cookson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raoul S. Concepcion
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Charles W. Eckstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sam S. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Joseph A. Smith Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jay H. Fowke.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fowke, J.H., Motley, S.S., Wills, M. et al. Prostate volume modifies the association between obesity and prostate cancer or high-grade prostatic intraepithelial neoplasia. Cancer Causes Control 18, 375–384 (2007). https://doi.org/10.1007/s10552-007-0119-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-007-0119-x

Keywords

Search

Navigation