1: Tall height and obesity are associated with increased risk of aggressive prostate cancer and death
Results from the large prospective EPIC study have shown that men who are taller or obese have a higher risk of developing advanced prostate cancer and from dying of prostate cancer. While this work is consistent with previous studies, the large size of the cohort (141,896 men, 7024 cases of prostate cancer) and long follow up (13.9 years) allowed the investigators to distinguish between the risk of high-grade cancer and death from prostate cancer.
The analysis found that taller height increased the risk of high-grade (HR 1.54; [CI] 1.18-2.03; p=0.006) but not low or intermediate grade prostate cancer. Taller height was also associated with an increased risk of prostate cancer death (HR [CI] 1.43, 1.14-1.80; p=0.001). Looked at another way, for every 10cm increase in height there was an 21% or 17% increased risk of high-grade disease or prostate cancer death respectively. Similarly, the study found a statistically significant increased risk of high-grade cancer and prostate cancer death with increasing BMI or waist circumference. Hazard ratios for prostate cancer death were 1.35 [CI] 1.09-1.68 and 1.55 [CI] 1.23-1.96 for increased BMI and waist circumference respectively. Interestingly, obesity was associated with a reduced risk of being diagnosed with low-risk prostate cancer. The authors suggest that since men with a high BMI are less likely to be diagnosed with prostate cancer (due to a combination of lower PSA concentrations and difficulties in performing accurate DREs) they are more likely to present with advanced disease. Overall, this paper adds more evidence to the link between body size and prostate cancer.