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Systematic review of prostate cancer’s association with body size in childhood and young adulthood

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Abstract

Body size relatively early in life may influence men’s later rate of prostate cancer. We searched for published, English-language studies of the association between prostate cancer incidence or mortality and body size between ages 5 and 29 years. We summarized analyses of childhood body size, early-adult waist circumference, and early-adult body mass index (BMI). Most study designs were case–control or retrospective cohort studies, in which body size was self-reported and recalled. The few studies of childhood body size and early-adult waist circumference indicated null or weak associations. The results from studies of early-adult BMI were heterogeneous (p = 0.04) and showed evidence of funnel plot asymmetry. The random-effects rate ratio (RR) was 1.06 (95% confidence interval [CI]: 0.99, 1.14) per five-unit increase in BMI. Studies using measured (as opposed to self-recalled) height and weight (n = 3) tended to produce stronger associations: fixed-effects summary RR = 1.22 (1.06, 1.39). The same was true for studies that did not adjust for later-life BMI (n = 13): fixed-effects RR = 1.13 (1.06, 1.21). Examining only analyses of advanced or high-grade prostate cancers, results were heterogeneous (p < 0.01). The random-effects summary RR per five units of BMI was 1.01 (95% CI: 0.89, 1.15). In all the reviewed studies, the vast majority of men were of normal weight in childhood and early adulthood. Few studies presented data describing the association between prostate cancer and obesity (e.g., early-adult BMI ≥ 30). The exact relationships between early-life body size and prostate cancer remain unclear but appear to be weak.

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References

  1. Freedland SJ, Platz EA (2007) Obesity and prostate cancer: making sense out of apparently conflicting data. Epidemiol Rev 29:88–97

    Article  PubMed  Google Scholar 

  2. MacInnis RJ, English DR (2006) Body size and composition and prostate cancer risk: systematic review and meta-regression analysis. Cancer Causes Control 17(8):989–1003

    Article  PubMed  Google Scholar 

  3. Whittemore AS, Paffenbarger RS Jr, Anderson K, Lee JE (1984) Early precursors of urogenital cancers in former college men. J Urol 132(6):1256–1261

    PubMed  CAS  Google Scholar 

  4. Whittemore AS, Paffenbarger RS Jr, Anderson K, Lee JE (1985) Early precursors of site-specific cancers in college men and women. J Natl Cancer Inst 74(1):43–51

    PubMed  CAS  Google Scholar 

  5. Ilic M, Vlajinac H, Marinkovic J (1996) Case–control study of risk factors for prostate cancer. Br J Cancer 74(10):1682–1686

    PubMed  CAS  Google Scholar 

  6. Dal Maso L, Zucchetto A, La Vecchia C, Montella M, Conti E, Canzonieri V et al (2004) Prostate cancer and body size at different ages: an Italian multicentre case–control study. Brit J Cancer 90(11):2176–2180

    PubMed  CAS  Google Scholar 

  7. Friedenreich CM, McGregor SE, Courneya KS, Angyalfi SJ, Elliott FG (2004) Case–control study of anthropometric measures and prostate cancer risk. Int J Cancer 110(2):278–283

    Article  PubMed  CAS  Google Scholar 

  8. Greenwald P, Damon A, Kirmss V, Polan AK (1974) Physical and demographic features of men before developing cancer of the prostate. J Natl Cancer Inst 53(2):341–346

    PubMed  CAS  Google Scholar 

  9. Nomura A, Heilbrun LK, Stemmermann GN (1985) Body mass index as a predictor of cancer in men. J Natl Cancer Inst 74(2):319–323

    PubMed  CAS  Google Scholar 

  10. Andersson SO, Baron J, Wolk A, Lindgren C, Bergstrom R, Adami HO (1995) Early life risk factors for prostate cancer: a population-based case–control study in Sweden. Cancer Epidemiol Biomarkers Prev 4(3):187–192

    PubMed  CAS  Google Scholar 

  11. Cerhan JR, Torner JC, Lynch CF, Rubenstein LM, Lemke JH, Cohen MB et al (1997) Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes Control 8(2):229–238

    Article  PubMed  CAS  Google Scholar 

  12. Giovannucci E, Rimm EB, Stampfer MJ, Colditz GA, Willett WC (1997) Height, body weight, and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 6(8):557–563

    PubMed  CAS  Google Scholar 

  13. Key TJ, Silcocks PB, Davey GK, Appleby PN, Bishop DT (1997) A case–control study of diet and prostate cancer. Br J Cancer 76(5):678–687

    PubMed  CAS  Google Scholar 

  14. Hsing AW, Deng J, Sesterhenn IA, Mostofi FK, Stanczyk FZ, Benichou J et al (2000) Body size and prostate cancer: a population-based case–control study in China. Cancer Epidemiol Biomarkers Prev 9(12):1335–1341

    PubMed  CAS  Google Scholar 

  15. 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(6):541–549

    PubMed  CAS  Google Scholar 

  16. Lee IM, Sesso HD, Paffenbarger RS Jr (2001) A prospective cohort study of physical activity and body size in relation to prostate cancer risk (United States). Cancer Causes Control 12(2):187–193

    Article  PubMed  CAS  Google Scholar 

  17. Okasha M, McCarron P, McEwen J, Smith GD (2002) Body mass index in young adulthood and cancer mortality: a retrospective cohort study. J Epidemiol Community Health 56(10):780–784

    Article  PubMed  CAS  Google Scholar 

  18. Engeland A, Tretli S, Bjorge T (2003) Height, body mass index, and prostate cancer: a follow-up of 950000 Norwegian men. Br J Cancer 89(7):1237–1242

    Article  PubMed  CAS  Google Scholar 

  19. Giles GG, Severi G, English DR, McCredie MR, MacInnis R, Boyle P et al (2003) Early growth, adult body size and prostate cancer risk. Int J Cancer 103(2):241–245

    Article  PubMed  CAS  Google Scholar 

  20. Jonsson F, Wolk A, Pedersen NL, Lichtenstein P, Terry P, Ahlbom A et al (2003) Obesity and hormone-dependent tumors: cohort and co-twin control studies based on the Swedish Twin Registry. Int J Cancer 106(4):594–599

    Article  PubMed  CAS  Google Scholar 

  21. Robinson WR, Stevens J, Gammon MD, John EM (2005) Obesity before age 30 years and risk of advanced prostate cancer. Am J Epidemiol 161(12):1107–1114

    Article  PubMed  Google Scholar 

  22. Wright ME, Chang SC, Schatzkin A, Albanes D, Kipnis V, Mouw T et al (2007) Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Cancer 109(4):675–684

    Article  PubMed  Google Scholar 

  23. Liu X, Rybicki BA, Casey G, Witte JS (2005) Relationship between body size and prostate cancer in a sibling based case–control study. J Urol 174(6):2169–2173

    Article  PubMed  Google Scholar 

  24. Littman AJ, White E, Kristal AR (2007) Anthropometrics and prostate cancer risk. Am J Epidemiol 165(11):1271–1279

    Article  PubMed  Google Scholar 

  25. Cox B, Sneyd MJ, Paul C, Skegg DCG (2006) Risk factors for prostate cancer: A national case–control study. Int J Cancer 119(7):1690–1694

    Article  PubMed  CAS  Google Scholar 

  26. Greene F, Page D, Fleming I, Fritz A, Balch C, Haller D et al (2002) AJCC cancer staging manual, 6th edn. Springer

  27. Gleason D (1977) Histologic grading and clinical staging of prostatic carcinoma. In: Tannenbaum M (ed) Urologic pathology: the prostate. Lea and Febiger, Philadelphia, pp 171–198

  28. Weinberg CR (1993) Toward a clearer definition of confounding. Am J Epidemiol 137(1):1–8

    PubMed  CAS  Google Scholar 

  29. Rothman KJ, Greenland S (1998) Modern epidemiology, 2nd edn. Lippincott-Raven, Philadelphia, 125 pp

  30. Kleinbaum DG, Kupper LL, Morgenstern H (1982) Epidemiologic research: principles, quantitative methods. Lifetime Learning Publications, Belmont, CA, 257 pp

  31. Greenland S, Pearl J, Robins JM (1999) Causal diagrams for epidemiologic research. Epidemiology 10(1):37–48

    Article  PubMed  CAS  Google Scholar 

  32. Breslow NE, Day NE (1980) Statistical methods in cancer research, vol I - the analysis of case–control studies. IARC Sci Publ. (32), 107 pp

  33. Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 135(11):1301–1309

    PubMed  CAS  Google Scholar 

  34. Orsini N, Bellocco R, Greenland S (2006) Generalized least squares for trend estimation of summarized dose-response data. Stata J 6(1):40–57

    Google Scholar 

  35. Sterne JA, Gavaghan D, Egger M (2000) Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol 53(11):1119–1129

    Article  PubMed  CAS  Google Scholar 

  36. Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101

    Article  PubMed  CAS  Google Scholar 

  37. Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical Research Ed) 315(7109):629–634

    CAS  Google Scholar 

  38. Duval S, Tweedie R (2000) A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc 95(449):89–98

    Article  Google Scholar 

  39. Duval S, Tweedie R (2000) Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56(2):455–463

    Article  PubMed  CAS  Google Scholar 

  40. Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21(11):1559–1573

    Article  PubMed  Google Scholar 

  41. Thompson SG, Sharp SJ (1999) Explaining heterogeneity in meta-analysis: a comparison of methods. Stat Med 18(20):2693–2708

    Article  PubMed  CAS  Google Scholar 

  42. Sharp SJ (1998) Meta-analysis regression. Stata Tech Bull 42:16–22

    Google Scholar 

  43. Wright ME, Chang SC, Schatzkin A, Albanes D, Kipnis V, Mouw T et al (2007) Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality. Cancer 109(4):675–684

    Article  PubMed  Google Scholar 

  44. Freedland SJ, Aronson WJ (2005) Obesity and prostate cancer. Urology 65(3):433–439

    Article  PubMed  Google Scholar 

  45. Troiano RP, Flegal KM (1998) Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics 101(3 Pt 2):497–504

    PubMed  CAS  Google Scholar 

  46. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22(1):39–47

    Article  PubMed  CAS  Google Scholar 

  47. Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL (1995) Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med 149(10):1085–1091

    PubMed  CAS  Google Scholar 

  48. Gong Z, Neuhouser ML, Goodman PJ, Albanes D, Chi C, Hsing AW et al (2006) Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 15(10):1977–1983

    Article  PubMed  Google Scholar 

  49. Stevens J, Keil JE, Waid LR, Gazes PC (1990) Accuracy of current, 4-year, and 28-year self-reported body weight in an elderly population. Am J Epidemiol 132(6):1156–1163

    PubMed  CAS  Google Scholar 

  50. Juni P, Witschi A, Bloch R, Egger M (1999) The hazards of scoring the quality of clinical trials for meta-analysis. JAMA 282(11):1054–1060

    Article  PubMed  CAS  Google Scholar 

  51. Greenland S, O’Rourke K (2001) On the bias produced by quality scores in meta-analysis, and a hierarchical view of proposed solutions. Biostatistics 2(4):463–471

    Article  PubMed  CAS  Google Scholar 

  52. Freedland SJ, Giovannucci E, Platz EA (2006) Are findings from studies of obesity and prostate cancer really in conflict? Cancer Causes Control 17(1):5–9

    Article  PubMed  Google Scholar 

  53. Rodriguez C, Freedland SJ, Deka A, Jacobs EJ, McCullough ML, Patel AV et al (2007) 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 

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Acknowledgments

We thank the following study authors and staff members for their generous help and correspondence: James R. Cerhan; Brian Cox; Anders Engeland; Graham G. Giles; Ed Giovannucci; Christine M. Friedenreich; Peter Greenwald; Ann W. Hsing; M. Ilic, H. Vlajinac, and Sandra Grujicic; F. Jonsson and Maria Feychting; T. J. Key and Paul N. Appleby; I-Min Lee; Xin Liu and John Witte; Abe Nomura and Grant N. Stemmerman; Mona (Okasha) Jeffreys; Agnes G. Schuurman and P. A. van den Brandt; Alice S. Whittemore; and Margaret E. Wright. The following people assisted us in finding study authors or study information: George Rhoads, Sven-Olof Andersson, Pieter C. Dagnelie, Leo Schouten, and Marjan van den Akker. We extend special appreciation to Sean Cody at the NIH/NHLBI for providing information from the A. N. et al. study. Cande Ananth wrote the SAS code used for generalized least-squares trend (GLST) estimation. Financial support: Dr. Poole received partial support for this work from NIEHS grant P30ES10126. Ms. Robinson received support from the Thomas S. and Caroline H. Royster, Jr. Fellowship (University of North Carolina, Chapel Hill); the Center for Human Science; and grant T32-CA09330 from the National Cancer Institute.

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Robinson, W.R., Poole, C. & Godley, P.A. Systematic review of prostate cancer’s association with body size in childhood and young adulthood. Cancer Causes Control 19, 793–803 (2008). https://doi.org/10.1007/s10552-008-9142-9

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