Height, Adiposity Associated With High-Grade Prostate Cancer, Death

Taller men are at increased risk for high-grade prostate cancer and prostate cancer death, according to a large registry study. Greater adiposity is also associated with higher-grade tumors and mortality.

“While relatively little is known about prostate cancer etiology, hormones have been implicated; for example, circulating insulin-like growth factor I concentrations are associated with prostate cancer risk,” wrote study authors led by Aurora Pérez-Cornago, PhD, of the University of Oxford in the United Kingdom. “A relatively large body size has been proposed to influence several metabolic and hormonal mechanisms that can promote cancer development.”

The researchers analyzed data from the European Prospective Investigation Into Cancer and Nutrition (EPIC) study. Out of 141,896 men included in the study, a total of 7,024 were diagnosed with prostate cancer after an average of 13.9 years of follow-up; there were 934 deaths from prostate cancer. Results of the analysis were published online ahead of print in BMC Medicine.

Height was not associated with overall prostate cancer risk; the highest fifth of patients had a hazard ratio (HR) for prostate cancer compared with the lowest fifth of 1.06 (95% CI, 0.97–1.15; P for trend = .3). Height was, however, positively associated with high-grade disease, with an HR of 1.54 (95% CI, 1.18–2.03; P for trend = .006), though not with low-intermediate-grade disease.

Taller height was also associated with a higher risk for death due to prostate cancer, with an HR of 1.43 (95% CI, 1.14–1.80; P for trend = .001) for the highest fifth vs the lowest fifth. Each 10 cm increase in height was associated with a 21% increase in the risk of high-grade disease, and with a 17% increase in the risk of prostate cancer death.

Body-mass index (BMI) and waist circumference were inversely correlated with overall prostate cancer risk. The HR for the highest fifth of BMI vs the lowest was 0.90 (95% CI, 0.83–0.97; P for trend < .001). However, higher BMI was associated with an increased risk for high-grade disease, at an HR of 1.32 (95% CI, 1.01–1.72). This was similar for waist circumference, and both BMI and waist circumference were positively associated with the risk of prostate cancer death.

“Our data illustrate the complex association of adiposity and prostate cancer, which varies by disease aggressiveness,” Pérez-Cornago said in a press release. “The results emphasize the importance of studying risks for prostate cancer separately by stage and grade of tumor. They may also inform strategies for prevention, but we need to do further work to understand why the differences in risk exist.”