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Overall and central obesity and prostate cancer risk in African men

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Abstract

Purpose

African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central obesity with risks of total and aggressive PCa among African men.

Methods

Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center, hospital-based case–control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively.

Results

Among controls 16.4% were obese (BMI ≥ 30 kg/m2), 26% and 90% had WC > 97 cm and WHR > 0.9, respectively. Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa, suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99–1.93), and central obesity (WC > 97 cm: OR = 1.60, 95% CI 1.10–2.33; and WHtR > 0.59: OR = 1.68, 95% CI 1.24–2.29) were positively associated with D’Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in West versus South Africa, but these differences were not statistically significant.

Discussion

The high prevalence of overall and central obesity in African men and their association with intermediate-risk PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of obesity and PCa in various African populations.

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Fig. 1

Abbreviation: BMI body mass index, WHR waist-to-hip ratio, WHtR waits-to-height ratio

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Data availability

The data that support the findings of this study are available upon request from the corresponding authors or the Principal Investigator of the MADCaP Network. The data are not publicly available due to privacy or ethical restrictions. Requests for data access can be submitted via the MADCaP Network website at: https://www.madcapnetwork.org/.

Code availability

R coding and Stata programs that were used for data analyses are available upon request from the corresponding authors.

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Acknowledgments

This work was supported by Public Health Service (PHS) Grant U01-CA184374 from the U.S. National Cancer Institute (NCI), National Institute of Health (NIH). We thank study participants as well as research and clinical staff of the participating hospitals in Senegal (Hôpital Général de Grand Yoff, Dakar), Ghana (Korle-Bu Teaching Hospital/University of Ghana, and 37 Military Hospital, both in Accra), Nigeria (University College Hospital/University of Ibadan, Ibadan, and University of Abuja Teaching Hospital/University of Abuja, Abuja), and South Africa (Tygerberg Hospital/Stellenbosch University, Cape Town, and the Chris Hani Baragwanath Academic Hospital/University of the Witwatersrand (Wits) and Wits Health Consortium, Johannesburg). The four twinning centers in the United States were: Albert Einstein College of Medicine (Bronx, New York), Columbia University Irving Medical Center (New York, New York), Dana-Farber Cancer Institute (DFCI, Boston, Massachusetts); and Stanford Cancer Institute, Stanford University (Stanford, California). We also thank Dana-Farber Cancer Institute/Harvard Cancer Center, for the use of the Survey and Data Management Core, which provided database services and support for this project; these centers were supported in part by an NCI Cancer Center Support Grant (P30 CA06516).

Funding

Supported by Grant U01-CA184374 from the U.S. National Cancer Institute, NIH.

Author information

Author notes

  1. Akindele Olupelumi Adebiyi and Ann W. Hsing have contributed equally as senior authors.

Authors and Affiliations

  1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA

    Ilir Agalliu, Janice S. Zhang & Thomas E. Rohan

  2. Stanford School of Medicine, Stanford Cancer Institute, Stanford University, Stanford, CA, USA

    Wei-Kaung Jerry Lin, Janice S. Zhang & Ann W. Hsing

  3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Judith S. Jacobson

  4. 37 Military Hospital, Accra, Ghana

    Ben Adusei & Nana Yaa F. Snyper

  5. Dana Farber Cancer Institute, Boston, MA, USA

    Caroline Andrews, Elkhansa Sidahmed & Timothy R. Rebbeck

  6. Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Elkhansa Sidahmed & Timothy R. Rebbeck

  7. Korle-Bu Teaching Hospital and University of Ghana, Accra, Ghana

    James E. Mensah, Richard Biritwum & Victoria Okyne

  8. College of Health Sciences, University of Ghana Medical School, Accra, Ghana

    Andrew A. Adjei

  9. College of Health Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana

    Joana Ainuson-Quampah

  10. Stellenbosch University, Cape Town, South Africa

    Pedro Fernandez & Hayley Irusen

  11. College of Medicine and University College Hospital, University of Ibadan, Ibadan, Nigeria

    Emeka Odiaka, Oluyemisi Folake Folasire, Makinde Gabriel Ifeoluwa & Akindele Olupelumi Adebiyi

  12. College of Health Sciences, University of Abuja, and University of Abuja Teaching Hospital and Cancer Science Centre, Abuja, Nigeria

    Oseremen I. Aisuodionoe-Shadrach & Maxwell Madueke Nwegbu

  13. Non-Communicable Diseases Research Division, Wits Health Consortium (Pty) Ltd, Johannesburg, South Africa

    Audrey Pentz, Wenlong Carl Chen & Maureen Joffe

  14. National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa

    Wenlong Carl Chen

  15. Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Wenlong Carl Chen

  16. SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Maureen Joffe

  17. Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA

    Alfred I. Neugut

  18. Institut de Formation et de la Recherche en Urologie et de la Santé Familiale, Hôpital Général de Grand Yoff, Dakar, Senegal

    Thierno Amadou Diallo & Mohamed Jalloh

  19. Stanford Prevention Research Center, Department of Medicine, Stanford School of Medicine, Stanford University, Stanford, CA, USA

    Ann W. Hsing

  20. Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford University, Stanford, CA, USA

    Ann W. Hsing

  21. Stanford Cancer Institute, 780 Welch Road, Room 250D, Stanford, CA, 94305, USA

    Ann W. Hsing

Authors
  1. Ilir Agalliu
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  2. Wei-Kaung Jerry Lin
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Contributions

IA, AOA, AWH had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: IA, AWH, AOA, TRR, JSJ, TER. Data acquisition and management: All authors. Statistical analysis: WKL, IA, AWH. Interpretation of data: All authors. Drafting of manuscript: IA, WKL, JSZ, AOA, AWH, JSJ, TER. Critical revision of manuscript for important intellectual content: All authors. Supervision: IA, AWH, AOA, TRR.

Corresponding authors

Correspondence to Ilir Agalliu, Akindele Olupelumi Adebiyi or Ann W. Hsing.

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The study protocol and procedures were approved by the Institutional Ethical Review Boards (IRBs) of all participating institutions.

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All cases and controls provided written informed consent to participate in the study.

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Agalliu, I., Lin, WK.J., Zhang, J.S. et al. Overall and central obesity and prostate cancer risk in African men. Cancer Causes Control 33, 223–239 (2022). https://doi.org/10.1007/s10552-021-01515-0

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