Obesity and Prostate Cancer: Weighing the Evidence

Allott, Emma H.; Masko, Elizabeth M.; Freedland, Stephen J.

doi:10.1016/j.eururo.2012.11.013

Cited by 491 publications

(415 citation statements)

References 95 publications

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“…In Korea, Park et al 14 found that the cancer detection rate in a sample of Korean men with a PSA level between 3.0 and 4.0 ng ml 21 was 26%. The PCa detection rate for non-palpable lesions among Korean men was 21.8% in those with a PSA level of 2.5-4.0 ng ml 21 and 20.2% in those with a PSA level of 4.0-10.0 ng ml 21 , with no statistically significant difference between groups. 15 The pathologic characteristics of prostatectomy specimens were also similar between the two groups.…”

Section: Discussionmentioning

confidence: 84%

“…Kobayashi et al 13 reported a 23.6% cancer detection rate in a Japanese sample, with PSA levels between 2.0 and 4.0 ng ml 21 . In Korea, Park et al 14 found that the cancer detection rate in a sample of Korean men with a PSA level between 3.0 and 4.0 ng ml 21 was 26%.…”

Section: Discussionmentioning

confidence: 97%

“…Catalona et al 12 proposed lowering the PSA cutoff from 4.0 to 2.5 ng ml 21 for performing a prostate biopsy to increase the detection rate of curable PCa. Kobayashi et al 13 reported a 23.6% cancer detection rate in a Japanese sample, with PSA levels between 2.0 and 4.0 ng ml 21 .…”

Section: Discussionmentioning

confidence: 99%

“…15 The pathologic characteristics of prostatectomy specimens were also similar between the two groups. 15 Many Korean institutions have adopted a PSA cutoff value of 2.5 ng ml 21 to prompt prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…[18][19][20] However, we hypothesize that the association between obesity and advanced disease will persist if obesity is biologically linked with aggressive disease. 21 Indeed, a meta-analysis of multiple prospective Obesity-related lowered PSA on PCa screening WJ Yang 771 studies found that although obesity has a null or slightly protective effect in localized disease, it is associated with an increased incidence of advanced PCa. 22 It is known that there is no single PSA threshold that can accurately classify PCa risk from a screening standpoint.…”

Section: Discussionmentioning

confidence: 99%

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The likelihood of having a serum PSA level of ≥2.5 or ≥4.0 ng ml−1 according to obesity in a screened Korean population

Yang¹

2013

Asian J Androl

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The likelihood of having a serum PSA level of o2.5 or o4.0 ng ml 21 according to obesity in a screened Korean population Won Jae YangThis study aimed to determine if lower serum total prostate-specific antigen (PSA) levels in obese Korean men affect prostate cancer (PCa) screening, as an increased body mass index (BMI) is inversely associated with the PSA level. Between March 2007 and December 2012, 22 208 native Korean men who were eligible to receive a serum PSA test were recruited. Logistic regression was used to estimate the odds of an 'abnormal' PSA (o2.5 or o4.0 ng ml 21 ) in these men (age: 45-75 years, PSA ,10 ng ml 21 ) based on BMI, which was categorized as normal (BMI ,25 kg m 22 ) and obese (BMI o25 kg m 22 ). In all, 20 509 men (92.3%) were included in the study after applying the inclusion criteria. After controlling for age, there was a statistically significant trend towards a lower likelihood of having a serum PSA level o2.5 ng ml 21 with an increased BMI, with obese men having an 18% lower likelihood (odds ratio: 0.823, 95% confidence interval: 0.743-0.912; P,0.001) compared to men with a normal BMI. Obese men were approximately 82% as likely to have a PSA level o2.5 ng ml 21 as men with a normal BMI. These results might affect PCa screening using serum total PSA. Further studies are needed to better define these results in clinical biopsy practice.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The likelihood of having a serum PSA level of ≥2.5 or ≥4.0 ng ml−1 according to obesity in a screened Korean population

Yang¹

2013

Asian J Androl

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Risk of Colorectal Cancer Associated With Lifetime Excess Weight

Jansen

Chang‐Claude

et al. 2022

JAMA Oncol

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xcess weight is an established risk factor for colorectal cancer (CRC), 1 and the prevalence of excess weight is rapidly increasing in many parts of the world. 2 According to the World Health Organization, at least 300 million adults worldwide have obesity and 1.4 billion have overweight. 3 Most epidemiologic studies have assessed associations of CRC with excess weight ascertained at a single point of time. 4 However, exposure to excess weight throughout the life span is likely to be more relevant for CRC risk, especially considering that one of the suggested underlying mechanisms is the continuous release of growth factors and steroids within an environment of chronic inflammation and insulin resistance. 5 Calculation of cumulative lifetime exposure has become a standard measure for other risk factors. For example, pack-years are widely used as a measure of lifetime cumulative smoking exposure and have been shown to be associated with the risk of a variety of smoking-related diseases, including multiple cancers. [6][7][8] By contrast, such measures have not been widely used for other risk factors, such as excess weight. In the present study, we aimed to derive a measure of cumulative lifetime exposure to excess weight and assess the strength of its association with risk of CRC in a large, population-based case-control study conducted in Germany. IMPORTANCE Excess weight is associated with increased cancer risk, but the risk may have been underestimated, as previous studies did not consider cumulative lifetime exposure.OBJECTIVE To assess the association of cumulative lifetime excess weight with risk of colorectal cancer (CRC). DESIGN, SETTING, AND PARTICIPANTSIn a population-based case-control study conducted since 2003 in Germany, height and self-reported weight documented in 10-year increments starting at age 20 years up to the current age were obtained from 5635 individuals with CRC and 4515 persons serving as controls. Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, was calculated for each year of age from age 20 years to the current age by linear interpolation. Excess BMI (eBMI) at each year of age was determined as BMI − 25 and summed across ages to obtain the weighted number of years lived with overweight or obesity (WYOs), determined as year × eBMI. The eBMI was set to 0 in case of a BMI below 25. Associations with CRC risk were estimated for BMI at various ages and for WYOs by multiple logistic regression. Data analyses were performed from June 4, 2021, to December 17, 2021. MAIN OUTCOMES AND MEASURESRelative risk of CRC according to lifetime exposure to excess weight compared with relative risks according to BMI at various ages. RESULTSThe mean (SD) age of the patients with CRC (n = 5635) was 68.4 (10.9) years; 3366 were men (59.7%); mean (SD) age of the control participants (n = 4515) was 68.5 (10.6) years; 2759 were men (61.1%). An association was observed between WYOs and CRC risk, with adjusted odds ratios (ORs) increasing from 1.25 (95% CI, 1.09-1.44...

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BMI trajectories and risk of overall and grade‐specific prostate cancer: An observational cohort study among men seen for prostatic conditions

et al. 2018

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BackgroundDynamic longitudinal patterns in body mass index (BMI) have been suggested to better predict health outcomes than static measures. Effects of BMI trajectories on prostate cancer (PCa) risk have not been thoroughly explored.MethodsCohort data were derived from electronic medical records of patients who were admitted to a tertiary‐care hospital in the Southeastern USA during 1994‐2016. Patients with a history of urologic clinic visit because of any prostatic condition and with repeatedly measured BMI (n = 4857) were included. BMI trajectories prior to PCa diagnosis were assessed using the developmental trajectory analysis method. Cox proportional hazards regression modeling was used to estimate adjusted hazard ratio (aHR) with 95% confidence intervals (CIs) for overall and grade‐specific PCa.ResultsThe median age (interquartile range, IQR) of the participants at baseline was 63 (54, 72) years. Over a median follow‐up (IQR) of 8.0 (2.0, 13.0) years, 714 (14.7%, 714/4857) were diagnosed with PCa. Men with growing BMI trajectory progressing from normal weight to overweight/obese had a 76% increased PCa risk (aHR = 1.76; 95% CI: 1.25, 2.48), and men being obese and experiencing progressive weight gain had 3.72‐fold increased PCa risk (aHR = 3.72; 95% CI: 1.60, 8.66), compared to men with persistently normal BMI. The associations were more pronounced for PCa with Gleason score ≥7. No significant association of decreasing BMI trajectory progressing from obese to normal BMI was found with PCa risk.ConclusionsProgressively body weight gain during middle‐to‐late adulthood was associated with increased PCa risk for both normal weight and overweight men. Further studies are warranted to confirm this finding.

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Obesity and Prostate Cancer: Weighing the Evidence

Cited by 491 publications

References 95 publications

The likelihood of having a serum PSA level of ≥2.5 or ≥4.0 ng ml−1 according to obesity in a screened Korean population

The likelihood of having a serum PSA level of ≥2.5 or ≥4.0 ng ml−1 according to obesity in a screened Korean population

Risk of Colorectal Cancer Associated With Lifetime Excess Weight

BMI trajectories and risk of overall and grade‐specific prostate cancer: An observational cohort study among men seen for prostatic conditions

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