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High bone density is associated with prostate cancer in older Afro-Caribbean men: Tobago Prostate Survey

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Abstract

Objective

To test the hypothesis that bone mineral density (BMD), a possible surrogate of lifetime exposure to hormone/growth factor/vitamin D/calcium exposure, is higher in prostate cancer cases than controls.

Methods

Hip BMD was measured by dual X-ray absorptiometry in 222 Afro-Caribbean screening-detected prostate cancer cases and 1,503 screened non-cases, aged 45–79, in the population-based Tobago Prostate Survey. Because possible skeletal metastases may modulate BMD, men with prostate specific antigen >20 ng/ml or highly undifferentiated tumors (Gleason score ≥8) were excluded. Mean BMD, adjusted for age and body mass index, was compared in cases and non-cases by analysis of variance. Risk across age group-specific BMD quartiles was compared using logistic regression.

Results

Overall, adjusted mean hip BMD was higher in cases (1.157 g/cm2) than non-cases (1.134 g/cm2) (p = 0.02). In men aged 60–79, prostate cancer risk was two-fold higher (OR, 2.12; 95% CI: 1.21–3.71) in the highest BMD quartile compared to the lowest. There was no association in younger men (interaction, p = 0.055).

Conclusions

High bone density is associated with prostate cancer among older men, consistent with an etiological role for lifetime exposure to factors which modulate bone density. However, other etiologies may dominate prostate cancer risk among younger men.

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Abbreviations

BMD:

Bone mineral density

BMI:

Body mass index

IGFI:

Insulin-like growth factor I

OR:

Odds ratio

PSA:

Prostate specific antigen

ANOVA:

Analysis of variance

NHANES:

National Health and Nutrition Examination Survey

SD:

Standard deviation

CI:

Confidence interval

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Author information

Authors and Affiliations

  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, A542 Crabtree Hall, 130 DeSoto Street, Pittsburgh, PA, 15261, USA

    Clareann H. Bunker, Joseph M. Zmuda, Alan L. Patrick, Joel L. Weissfeld, Lewis H. Kuller & Jane A. Cauley

  2. Tobago Health Studies Office, Scarborough, Tobago, Trinidad and Tobago

    Alan L. Patrick & Victor W. Wheeler

Authors
  1. Clareann H. Bunker
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  2. Joseph M. Zmuda
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  3. Alan L. Patrick
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  4. Victor W. Wheeler
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  5. Joel L. Weissfeld
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  6. Lewis H. Kuller
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  7. Jane A. Cauley
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Corresponding author

Correspondence to Clareann H. Bunker.

Additional information

The study was supported, in part, by funding or in-kind services from the Division of Health and Social Services, Tobago House of Assembly, the University of Pittsburgh Cancer Institute, the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, contract DAMD 17-99-109015, U.S. Department of Defense, and grants R01 CA84950, R25-CA57703, U.S. National Cancer Institute, R01-AR049747, U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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Bunker, C.H., Zmuda, J.M., Patrick, A.L. et al. High bone density is associated with prostate cancer in older Afro-Caribbean men: Tobago Prostate Survey. Cancer Causes Control 17, 1083–1089 (2006). https://doi.org/10.1007/s10552-006-0047-1

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  • DOI: https://doi.org/10.1007/s10552-006-0047-1

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