Background: Studies suggest obesity is associated with lower risk of prostate cancer (PC) but more aggressive cancers.
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As obesity lowers PSA levels, these observations may be influenced by detection bias. We examined the association between obesity and risk of low- and high-grade PC in REDUCE, where biopsies were largely independent of PSA.
Methods: The REDUCE study tested dutasteride for PC risk reduction in men with a PSA of 2.5-10.0 ng/mL and a negative biopsy. Study participants included 6,729 men who underwent at least one on-study biopsy. The association between baseline body mass index (BMI < 25 kg/m2-normal weight; 25-29.9 kg/m2-overweight; ≥30 kg/m2-obese) and risk of high-grade (Gleason >7) or low-grade PC (Gleason < 7) vs. no PC was examined using multinomial logistic regression.
Results: Overall, 1,739 men (27%) were normal weight, 3,384 (53%) overweight, and 1,304 (20%) were obese. Obesity was associated with lower risk of low-grade PC in both univariable (OR 0.74, p=0.001) and multivariable analyses (OR 0.79, p=0.01). In univariable analysis, obesity was not associated with high-grade PC (OR 1.08, p=0.50). However, in multivariable analysis, obesity was associated with increased risk of high-grade PC (OR 1.28, p=0.042). The current analysis was not able to address how obesity may influence prostate cancer progression.
Conclusions: Obesity is associated with decreased risk of low-grade and increased risk of high-grade PC. These data provide further support to the hypothesis that obesity is associated with aggressive PC.
Impact: Obesity is linked with aggressive PC. Avoiding obesity may prevent the risk of developing high-grade PC.
Vidal AC, Howard LE, Moreira DM, Castro-Santamaria R, Andriole GL Jr, Freedland SJ. Are you the author?
Surgery, Duke University; Department of Biostatistics and Bioinformatics, Duke University School of Medicine; Urology, The Author Smith Institute for Urology; GlaxoSmithKline; Division of Urology, Washington University School of Medicine; Division of Urology, Department of Surgery, Duke University School of Medicine.
Reference: Cancer Epidemiol Biomarkers Prev. 2014 Sep 27. pii: cebp.0795.2014.