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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study

Authors: Aurora Perez-Cornago, Paul N. Appleby, Tobias Pischon, Konstantinos K. Tsilidis, Anne Tjønneland, Anja Olsen, Kim Overvad, Rudolf Kaaks, Tilman Kühn, Heiner Boeing, Annika Steffen, Antonia Trichopoulou, Pagona Lagiou, Maria Kritikou, Vittorio Krogh, Domenico Palli, Carlotta Sacerdote, Rosario Tumino, H. Bas Bueno-de-Mesquita, Antonio Agudo, Nerea Larrañaga, Elena Molina-Portillo, Aurelio Barricarte, Maria-Dolores Chirlaque, J. Ramón Quirós, Pär Stattin, Christel Häggström, Nick Wareham, Kay-Tee Khaw, Julie A. Schmidt, Marc Gunter, Heinz Freisling, Dagfinn Aune, Heather Ward, Elio Riboli, Timothy J. Key, Ruth C. Travis

Published in: BMC Medicine | Issue 1/2017

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Abstract

Background

The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods

Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths.

Results

Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18–2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14–1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79–0.99 for low-intermediate grade and HR = 1.32, 1.01–1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75–0.99 for localised stage and HR = 1.11, 0.92–1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09–1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07–1.92) and fatal prostate cancer (HR = 1.55, 1.23–1.96).

Conclusions

The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.
Appendix
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Metadata
Title
Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study
Authors
Aurora Perez-Cornago
Paul N. Appleby
Tobias Pischon
Konstantinos K. Tsilidis
Anne Tjønneland
Anja Olsen
Kim Overvad
Rudolf Kaaks
Tilman Kühn
Heiner Boeing
Annika Steffen
Antonia Trichopoulou
Pagona Lagiou
Maria Kritikou
Vittorio Krogh
Domenico Palli
Carlotta Sacerdote
Rosario Tumino
H. Bas Bueno-de-Mesquita
Antonio Agudo
Nerea Larrañaga
Elena Molina-Portillo
Aurelio Barricarte
Maria-Dolores Chirlaque
J. Ramón Quirós
Pär Stattin
Christel Häggström
Nick Wareham
Kay-Tee Khaw
Julie A. Schmidt
Marc Gunter
Heinz Freisling
Dagfinn Aune
Heather Ward
Elio Riboli
Timothy J. Key
Ruth C. Travis
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0876-7

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