Cancer Causes & Control

, Volume 27, Issue 12, pp 1475–1485 | Cite as

The association of diabetes and obesity with prostate cancer aggressiveness among Black Americans and White Americans in a population-based study

  • Saira Khan
  • Jianwen Cai
  • Matthew E. Nielsen
  • Melissa A. Troester
  • James L. Mohler
  • Elizabeth T. H. Fontham
  • Laura H. Hendrix
  • Laura Farnan
  • Andrew F. Olshan
  • Jeannette T. Bensen
Original paper



Few studies have investigated the role of race in the association of diabetes and obesity with prostate cancer aggressiveness. Here we evaluate the independent association between diabetes and obesity with prostate cancer aggressiveness in White Americans and Black Americans.


Our cross-sectional, case-only study consisted of 1,058 White Americans and 991 Black Americans from the North Carolina-Louisiana Prostate Cancer (PCaP) project. Diabetes status was determined by self-report. Obesity was determined using body mass index and calculated based on anthropometric measurements. High aggressive prostate cancer was defined as Gleason sum ≥8, or prostate-specific antigen >20 ng/ml, or Gleason sum = 7 and clinical stage cT3–cT4. The association between diabetes and obesity with high aggressive prostate cancer at diagnosis was evaluated using multivariable logistic regression and adjusted for potential confounders.


Diabetes was not associated with high aggressive prostate cancer in the overall sample (OR 1.04; 95% CI 0.79, 1.37), White Americans (OR 1.00; 95% CI 0.65, 1.57) or Black Americans (OR 1.07; 95% CI 0.75, 1.53). Obesity, independent of diabetes, was positively associated with high aggressive prostate cancer in White Americans (OR 1.98; 95% CI 1.14, 3.43), but not in the overall sample (OR 1.37; 95% CI 0.99, 1.92) or Black Americans (OR 1.09; 95% CI 0.71, 1.67).


Diabetes was not associated with prostate cancer aggressiveness, overall, or in either race group. Obesity, independent of diabetes, was associated with high aggressive prostate cancer only in White Americans.


Prostrate cancer Aggressiveness Diabetes Obesity Black Americans PCaP 



The North Carolina-Louisiana Prostate Cancer Project (PCaP) is carried out as a collaborative study supported by the Department of Defense contract DAMD 17-03-2-0052. The authors thank the staff, advisory committees, and research subjects participating in the PCaP study for their important contributions. Dr. Khan was supported by T32190194 (Colditz) and by the foundation for Barnes Jewish Hospital and by Siteman Cancer Center. This content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.

Compliance with ethical standards

Conflict of interest

Saira Khan, PhD, MPH was a graduate research assistant in a position funded by GlaxoSmithKline. Dr. Khan’s work in that position is unrelated to this study. All other authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Animal rights statement

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Saira Khan
    • 1
    • 2
  • Jianwen Cai
    • 3
  • Matthew E. Nielsen
    • 1
    • 4
    • 5
  • Melissa A. Troester
    • 1
    • 5
  • James L. Mohler
    • 4
    • 5
    • 6
    • 7
  • Elizabeth T. H. Fontham
    • 8
  • Laura H. Hendrix
    • 5
  • Laura Farnan
    • 5
  • Andrew F. Olshan
    • 1
    • 5
  • Jeannette T. Bensen
    • 1
    • 5
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina-Chapel HillChapel HillUSA
  2. 2.Division of Public Health Sciences, Department of SurgeryWashington University in St. Louis School of MedicineSt. LouisUSA
  3. 3.Department of Biostatistics, Gillings School of Global Public HealthUniversity of North Carolina-Chapel HillChapel HillUSA
  4. 4.Department of Urology, School of MedicineUniversity of North Carolina-Chapel HillChapel HillUSA
  5. 5.Lineberger Comprehensive Cancer Center, School of MedicineUniversity of North Carolina-Chapel HillChapel HillUSA
  6. 6.Department of UrologyRoswell Park Cancer InstituteBuffaloUSA
  7. 7.Department of UrologyUniversity of Buffalo School of Medicine and BiotechnologyBuffaloUSA
  8. 8.School of Public HealthLouisiana State University Health Science CenterNew OrleansUSA

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