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Body mass index and weight change in men with prostate cancer: progression and mortality

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Abstract

Purpose

Body mass index (BMI) is a modifiable lifestyle factor that has been associated with an increased risk of fatal prostate cancer and biochemical recurrence. The main purpose of the present study was to investigate the association between the exposure BMI at the time of a prostate cancer diagnosis and weight change after diagnosis, and the outcomes of prostate cancer progression and mortality in a large cohort study.

Methods

Data from 4,376 men diagnosed with clinically localized prostate cancer between 1997 and 2002 were analyzed. BMI and weight change were self-reported in 2007. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were estimated in complete-case analysis (n = 3,214) using Cox proportional hazards models.

Results

Progression was experienced among 639 (14.6 %) of the study participants, and in total, 450 (10.3 %) deaths of any cause and 134 (3.1 %) prostate cancer-specific deaths were recorded during follow-up. Obese men had a 47 % increased rate of overall mortality compared to normal weight men (HR 1.47, 95 % CI 1.03–2.10). No statistically significant associations were found for BMI and prostate cancer progression or prostate cancer-specific mortality. A weight loss >5 % after diagnosis almost doubled the rate of overall mortality compared to maintaining a stable weight (HR 1.94, 95 % CI 1.41–2.66), while a weight gain >5 % was associated with an almost doubled increased rate of prostate cancer-specific mortality (HR 1.93, 95 % CI 1.18–3.16).

Conclusions

Being obese was associated with an increased rate of overall mortality, and gaining weight after a prostate cancer diagnosis was associated with an increased rate of prostate cancer-specific mortality.

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Acknowledgments

We thank all of the participants in the PROCAP study. We also thank Carin Cavalli-Björkman and Ami Rönnberg for their work during data collection and Michael Broms for his work with the databases. We also acknowledge the NPCR steering group and all the research nurses who extracted data for the follow-up study. The present study was supported by the Swedish Cancer Society, Grant No. CAN 2011/868, and the Swedish research Council for Health, Working life and Welfare, Grant No. 2011-0650.

Conflict of interest

The authors declare no conflict of interests.

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Authors and Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77, Stockholm, Sweden

    Stephanie E. Bonn, Fredrik Wiklund, Arvid Sjölander, Robert Szulkin, Henrik Grönberg & Katarina Bälter

  2. Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden

    Pär Stattin

  3. Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    Erik Holmberg

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  1. Stephanie E. Bonn
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  2. Fredrik Wiklund
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Correspondence to Stephanie E. Bonn.

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Bonn, S.E., Wiklund, F., Sjölander, A. et al. Body mass index and weight change in men with prostate cancer: progression and mortality. Cancer Causes Control 25, 933–943 (2014). https://doi.org/10.1007/s10552-014-0393-3

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  • DOI: https://doi.org/10.1007/s10552-014-0393-3

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