Abstract
Recent studies on the association between obesity and prostate cancer appear to be in conflict. A recent prospective cohort study reported that the incidence of prostate cancer was lower among obese men under the age of 60 years and among those men with a family history of prostate cancer. Similarly, a case–control study found obesity was inversely associated with prostate cancer risk in men aged 40–64 years. However, several prospective cohort studies found that obese men are more likely to die from prostate cancer than non-obese men. Finally, two recent studies found that among men with prostate cancer, obese men were more likely to have a biochemical progression after surgery. We postulate that by closely examining the comparison groups used in these studies, these findings may, in fact, be in agreement. Specifically, this paradox within the literature may result from the possibility that obesity influences the development of aggressive (i.e., higher stage, higher grade, recurrence, death) and non-aggressive disease differently. We suggest that obesity may reduce the risk of non-aggressive disease but simultaneously increase the risk of aggressive disease. Finally, additional methodological issues are discussed that investigators need to be aware of to be able to draw inferences across studies of obesity and prostate cancer outcomes.
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References
AM Nomura (2001) ArticleTitleBody size and prostate cancer Epi Rev 23 126–131 Occurrence Handle1:STN:280:DC%2BD3Mrkt1Sltg%3D%3D
E Giovannucci EB Rimm Y Liu et al. (2003) ArticleTitleBody mass index and risk of prostate cancer in U.S. health professionals J Natl Cancer Inst 95 1240–1244 Occurrence Handle12928350
MP Porter JL Stanford (2005) ArticleTitleObesity and the risk of prostate cancer Prostate 62 316–321 Occurrence Handle15389806 Occurrence Handle10.1002/pros.20121
CL Amling RH Riffenburgh L Sun et al. (2004) ArticleTitlePathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy J Clin Oncol 22 439–445 Occurrence Handle14691120
SJ Freedland WJ Aronson CJ Kane et al. (2004) ArticleTitleImpact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group J Clin Oncol 22 446–453 Occurrence Handle14691122
S Rohrmann WW Roberts PC Walsh EA Platz (2003) ArticleTitleFamily history of prostate cancer and obesity in relation to high-grade disease and extraprostatic extension in young men with prostate cancer Prostate 55 140–146 Occurrence Handle12661039 Occurrence Handle10.1002/pros.10211
SO Andersson A Wolk R Bergstrom et al. (1997) ArticleTitleBody size and prostate cancer: a 20-year follow-up study among 135006 Swedish construction workers J Natl Cancer Inst 89 385–389 Occurrence Handle1:STN:280:ByiB3MvlvVU%3D Occurrence Handle9060961 Occurrence Handle10.1093/jnci/89.5.385
C Rodriguez AV Patel EE Calle EJ Jacobs A Chao MJ Thun (2001) ArticleTitleBody mass index, height, and prostate cancer mortality in two large cohorts of adult men in the United States Cancer Epidemiol Biomarkers Prev 10 345–353 Occurrence Handle1:STN:280:DC%2BD3M3jtV2gtg%3D%3D Occurrence Handle11319175
EE Calle C Rodriguez K Walker-Thurmond MJ Thun (2003) ArticleTitleOverweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults N Engl J Med 348 1625–1638 Occurrence Handle12711737 Occurrence Handle10.1056/NEJMoa021423
R Pasquali F Casimirri S Cantobelli et al. (1991) ArticleTitleEffect of obesity and body fat distribution on sex hormones and insulin in men Metabolism 40 101–104 Occurrence Handle1:STN:280:By6D1c%2FntVw%3D Occurrence Handle1984562 Occurrence Handle10.1016/0026-0495(91)90199-7
S Slater RT Oliver (2000) ArticleTitleTestosterone: its role in development of prostate cancer and potential risk from use as hormone replacement therapy Drugs Aging 17 431–439 Occurrence Handle1:CAS:528:DC%2BD3MXnvFShtA%3D%3D Occurrence Handle11200304
GR Cunha SW Hayward YZ Wang WA Ricke (2003) ArticleTitleRole of the stromal microenvironment in carcinogenesis of the prostate Int J Cancer 107 1–10 Occurrence Handle1:CAS:528:DC%2BD3sXntlKmtr4%3D Occurrence Handle12925950 Occurrence Handle10.1002/ijc.11335
AV D’Amico MH Chen SB Malkowicz et al. (2002) ArticleTitleLower prostate specific antigen outcome than expected following radical prostatectomy in patients with high grade prostate and a prostatic specific antigen level of 4 ng/ml or less J Urol 167 2025–2030 Occurrence Handle11956431
JC Massengill L Sun JW Moul et al. (2003) ArticleTitlePretreatment total testosterone level predicts pathological stage in patients with localized prostate cancer treated with radical prostatectomy J Urol 169 1670–1675 Occurrence Handle12686805
MA Hoffman WC DeWolf A Morgentaler (2000) ArticleTitleIs low serum free testosterone a marker for high grade prostate cancer? J Urol 163 824–827 Occurrence Handle1:CAS:528:DC%2BD3cXhsVSjuro%3D Occurrence Handle10687985
G Schatzl S Madersbacher T Thurridl et al. (2001) ArticleTitleHigh-grade prostate cancer is associated with low serum testosterone levels Prostate 47 52–58 Occurrence Handle1:CAS:528:DC%2BD3MXjtVCju74%3D Occurrence Handle11304729 Occurrence Handle10.1002/pros.1046
EA Platz MF Leitzmann N Rifai et al. (2005) ArticleTitleSex 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 Occurrence Handle1:CAS:528:DC%2BD2MXktFCkt7k%3D Occurrence Handle15894683
IM Thompson PJ Goodman CM Tangen et al. (2003) ArticleTitleThe influence of finasteride on the development of prostate cancer N Engl J Med 349 215–224 Occurrence Handle1:CAS:528:DC%2BD3sXlsVGjsbs%3D Occurrence Handle12824459 Occurrence Handle10.1056/NEJMoa030660
R Talamini C Vecchia ParticleLa A Decarli E Negri S Franceschi (1986) ArticleTitleNutrition, social factors and prostatic cancer in a Northern Italian population Br J Cancer 53 817–821 Occurrence Handle1:STN:280:BimB2czgsVU%3D Occurrence Handle3718835
H Gronberg L Damber JE Damber (1996) ArticleTitleTotal 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 Occurrence Handle1:STN:280:BymC28vmsVc%3D Occurrence Handle8583620
SJ Freedland MK Terris EA Platz JC Presti SuffixJr (2005) ArticleTitleBody mass index as a predictor of prostate cancer: development versus detection on biopsy Urol 66 108–113 Occurrence Handle15992911 Occurrence Handle10.1016/j.urology.2005.01.060
J Baillargeon BH Pollock AR Kristal et al. (2005) ArticleTitleThe association of body mass index and prostate-specific antigen in a population-based study Cancer 103 1092–1095 Occurrence Handle15668913
LE Millender M Aubin J Pouliot K Shinohara M Roach Suffix3rd (2004) ArticleTitleDaily electronic portal imaging for morbidly obese men undergoing radiotherapy for localized prostate cancer Int J Radiat Oncol Biol Phys 59 6–10 Occurrence Handle15093893 Occurrence Handle10.1016/j.ijrobp.2003.12.027
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Supported by the NIH Specialized Programs of Research Excellence Grant P50CA58236 (EAP) and P50CA90381 (EG), the Department of Defense, Prostate Cancer Research Program, PC030666 (SJF) and DAMD 17-03-1-0273 (EAP), Fund for Research and Progress in Urology (EAP), and the American Foundation for Urological Disease/American Urological Association Education and Research Scholarship Award (SJF). Views and opinions of, and endorsements by the author(s) do not reflect those of the US Army or the Department of Defense
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Freedland, S.J., Giovannucci, E. & Platz, E.A. Are Findings from Studies of Obesity and Prostate Cancer Really in Conflict?. Cancer Causes Control 17, 5–9 (2006). https://doi.org/10.1007/s10552-005-0378-3
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DOI: https://doi.org/10.1007/s10552-005-0378-3