Obesity Affects the Biopsy-Mediated Detection of Prostate Cancer, Particularly High-Grade Prostate Cancer: A Dose-Response Meta-Analysis of 29,464 Patients

Hu, Mengbo; Liu, Shenghua; Jiang, Haowen; Bai, Peide; Ding, Qiang

doi:10.1371/journal.pone.0106677

Cited by 47 publications

(41 citation statements)

References 38 publications

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“…Similar relationships have been observed for PCa, although the findings are inconsistent; some studies report an association between obesity and increased PCa incidence , whilst others have shown no or only modest associations with PCa incidence . Meta‐analyses designed to examine robustly the association between obesity and PCa incidence are equally inconclusive .…”

Section: Obesity and Prostate Cancermentioning

confidence: 77%

“…This increase in PCa incidence has largely mirrored the increase in the prevalence of obesity and metabolic syndrome . While there are conflicting reports on the effect of obesity on PCa incidence , there is an increasing body of evidence demonstrating associations between obesity and more aggressive carcinoma, poor treatment outcome and higher risk of cancer‐specific mortality for PCa . A range of mechanisms have been proposed to underpin the effects of an obese environment on PCa behaviour, including increased systemic inflammation, hyperinsulinaemia, altered adipokine profiles and increased lipid availability .…”

Section: Introductionmentioning

confidence: 99%

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Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

et al. 2018

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Emerging data have linked certain features of clinical prostate cancer (PCa) to obesity and, more specifically, increased adiposity. Whereas the large number of clinical studies and meta-analyses that have explored the associations between PCa and obesity have shown considerable variability, particularly in relation to prostate cancer risk, there is an accumulating weight of evidence consistently linking obesity to greater aggressiveness of disease. In probing this association mechanistically, it has been posited that peri-prostatic adipose tissue (PPAT), a significant component of the prostate microenvironment, may be a critical source of fatty acids and other mitogens and thereby influences PCa pathogenesis and progression. Notably, several recent studies have identified secreted factors from both PPAT and PCa that potentially mediate the two-way communication between these intimately linked tissues. In the present review, we summarize the available literature regarding the relationship between PPAT and PCa, including the potential biological mediators of that relationship, and explore emerging areas of interest for future research endeavours.

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Section: Obesity and Prostate Cancermentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

et al. 2018

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“…Obesity may be salient to racial disparities in prostate cancer given that it is influenced by environmental and genetic factors, 7 is more prevalent among African Americans, 8,9 affects physiologic processes associated with cancer etiology, 10,11 and may affect the sensitivity of prostate-specific antigen (PSA) screening. 12,13 …”

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confidence: 99%

Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT)

et al. 2015

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IMPORTANCE African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. OBJECTIVE To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. DESIGN, SETTING, AND PARTICIPANTS Prospective study of 3398 African American and 22 673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001–2011) with present analyses completed in 2014. MAIN OUTCOMES AND MEASURES Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence. RESULTS With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91–1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38–2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58–1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17–4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90–1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79–4.11]; P for trend = .02). CONCLUSIONS AND RELEVANCE Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.

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“…Although individual studies are conflicted regarding the association between obesity and prostate cancer risk, a number of large meta-analyses have reported that obesity is associated with a modestly elevated total prostate cancer incidence (Bergstrom, et al 2001; Hu, et al 2014; MacInnis and English 2006; Renehan, et al 2008). One meta-analysis demonstrated that findings from the individual contributing studies differed by geographic region (Renehan et al 2008), thereby offering insight into these somewhat conflicted results.…”

Section: Transdisciplinary Insights Into Associations Between Obesmentioning

confidence: 99%

Obesity and cancer: mechanistic insights from transdisciplinary studies

Allott¹,

Hursting²

2015

Endocrine-Related Cancer

140

101

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Obesity is associated with a range of health outcomes that are of clinical and public health significance, including cancer. Herein, we summarize epidemiologic and preclinical evidence for an association between obesity and increased risk of breast and prostate cancer incidence and mortality. Moreover, we describe data from observational studies of weight change in humans and from calorie restriction studies in mouse models which support a potential role for weight loss in counteracting tumor-promoting properties of obesity in breast and prostate cancers. Given that weight loss is challenging to achieve and maintain, we also consider evidence linking treatments for obesity-associated co-morbidities, including metformin, statins and non-steroidal anti-inflammatory drugs, with reduced breast and prostate cancer incidence and mortality. Finally, we highlight several challenges that should be considered when conducting epidemiologic and preclinical research in the area of obesity and cancer, including the measurement of obesity in population-based studies, the timing of obesity and weight change in relation to tumor latency and cancer diagnosis, and the heterogeneous nature of obesity and its associated co-morbidities. Given that obesity is a complex trait, comprised of behavioral, epidemiologic and molecular/metabolic factors, we argue that a transdisciplinary approach is the key to understanding the mechanisms linking obesity and cancer. As such, this review highlights the critical need to integrate evidence from both epidemiologic and preclinical studies to gain insight into both biologic and non-biologic mechanisms contributing to the obesity-cancer link.

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Obesity Affects the Biopsy-Mediated Detection of Prostate Cancer, Particularly High-Grade Prostate Cancer: A Dose-Response Meta-Analysis of 29,464 Patients

Cited by 47 publications

References 38 publications

Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

Peri‐prostatic adipose tissue: the metabolic microenvironment of prostate cancer

Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT)

Obesity and cancer: mechanistic insights from transdisciplinary studies

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