medwireNews: A meta-analysis has identified a significantly elevated risk for prostate cancer-specific mortality with increases in BMI, waist circumference, and waist-to-hip ratio.
The associations “may be biologically driven and/or due to differences in detection,” as men with obesity can often have a delayed diagnosis due to their lower prostate-specific antigen levels, among other reasons, say the researchers in BMC Medicine.
But “[i]n either case, these findings support the benefit for men of maintaining a healthy body weight,” they emphasize.
The team drew on the UK Biobank study to identify 218,237 men who were cancer-free and aged an average of 56.5 years at recruitment. Of these, 661 died from prostate cancer over a mean follow-up of 11.6 years.
Multivariable analysis adjusting for a raft of factors such as age, ethnicity, geographic region, smoking status, and physical activity showed that each 0.05 increase in the waist-to-hip ratio was associated with a 7% increased risk for death from prostate cancer.
By contrast, there was no significant association between prostate cancer-specific mortality and BMI, total body fat percentage, or waist circumference.
The researchers then conducted a meta-analysis of the current data as well as other prospective cohort studies that examined the association between risk for prostate cancer-specific mortality and BMI (n=19 studies and 19,633 prostate cancer deaths), body fat percentage (n=2 and 670, respectively), waist circumference (n=6 and 3181, respectively), and waist-to-hip ratio (n=3 and 1639, respectively).
In this analysis, each 5 kg/m2 increase in BMI was associated with a significant 10% increased risk for prostate cancer-specific mortality, while every 10 cm increase in waist circumference raised the risk by 7% and each 0.05 increase in waist-to-hip ratio by 6%.
But once again, total body fat percentage did not appear to be significantly associated with prostate cancer-specific mortality risk.
In conclusion, Aurora Perez-Cornago and co-investigators from the University of Oxford in the UK draw attention to some limitations of their study, including the possibility of residual confounding and that of “misclassification of the underlying cause of death,” as “obese men with prostate cancer are at increased risk of dying from several conditions.”
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