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

Abstract

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.

Body mass index trajectories and prostate cancer risk: Results from the EPICAP study

“…To go further in the understanding of the relation between obesity and cancer risk, it has been suggested that BMI trajectory modeling may provide a more appropriate method to study the role of obesity in cancer risk compared to static measures of BMI. 10 To the best of our knowledge, only four studies have explored the association between body shapes 11 or BMI trajectories [12][13][14] and prostate cancer incidence or mortality. One study, based on body shapes trajectories, did not find any association with advanced prostate cancer, 11 while the three studies based on BMI trajectories observed a higher risk of overall 13 or aggressive/fatal prostate cancer [12][13][14] for men progressing from normal weight to overweight or obesity, compared to men with stable normal BMI, suggesting a role of life course obesity in prostate carcinogenesis.…”

“…In the meanwhile, BMI trajectories have been suggesting to better predict health outcomes than static measures. 10 To date, only four studies were able to investigate body shapes or BMI trajectories over adulthood on prostate cancer risk, [11][12][13][14] suggesting a higher risk of overall and aggressive prostate cancer for men progressing from normal weight to overweight or obesity, compared to men with stable normal BMI.…”

Distinct developmental trajectories of body mass index and diabetes risk: A 5‐year longitudinal study of Chinese adults

“…This method assumes that individual differences in trajectories can be summarized by a finite set of different polynomial functions of time. In the past years, this method has been successfully used to examine the association between BMI trajectories and the risk of hypertension, cancer and all‐cause mortality. However, to date, just a few studies have explored the association between BMI trajectories identified by GBTM and diabetes risk.…”

Risk of subsequent prostate cancer in peptic ulcer patients who received helicobacter pylori eradication therapy: an Asian population-based cohort study

“…Body mass index (BMI) is a good index to compare comorbidities for prostate cancer [43,44]. Because there was a lack of exact BMI values in our database, BMI was unable to be considered as a comorbidity for prostate cancer in this study.…”