Body mass index as a predictor of prostate cancer: Development versus detection on biopsy

Stephen J. Freedland, Martha K. Terris, Elizabeth A. Platz, Joseph C. Presti

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Objectives. To determine whether obesity is biologically associated with an increased risk of prostate cancer development, especially aggressive disease and to explore whether a bias may exist in our ability to detect these cancers in obese patients. Methods. We evaluated the association of body mass index (BMI) with prostate cancer, biopsy Gleason sum, and amount of cancer using logistic and linear regression analyses adjusting for age at biopsy, race, prostate-specific antigen level, digital rectal examination findings, and prostate volume among 787 consecutive men undergoing prostate biopsy between 1998 and 2002 at an equal-access medical center. Results. Men with a higher BMI were younger (P <0.001), had lower prostate-specific antigen concentrations (P = 0.02), fewer abnormal digital rectal examination findings (P = 0.02), and larger prostate volumes (P <0.001). After adjusting for age, no overall association was found between BMI and the odds of being diagnosed with cancer (P trend = 0.89), although overweight and mild obesity were inversely associated with the diagnosis of cancer. After multivariable adjustment, a higher BMI was associated with an increased odds of being diagnosed with prostate cancer (P trend = 0.007). Among men diagnosed with cancer, and after multivariable adjustment, a higher BMI was associated with a similar percentage of biopsy tissue with cancer (P trend = 0.23), but with greater odds of a high Gleason sum (P trend = 0.004). Conclusions. After taking into account the clinical characteristics that influence the likelihood of finding an existent cancer, a higher BMI was positively associated with being diagnosed with prostate cancer. Also, among the men with cancer, a higher BMI increased the odds of high-grade disease. These findings suggest that obesity may be biologically associated with prostate cancer development and, in particular, with high-grade disease.

Original languageEnglish (US)
Pages (from-to)108-113
Number of pages6
JournalUrology
Volume66
Issue number1
DOIs
StatePublished - Jul 1 2005

Fingerprint

Prostatic Neoplasms
Body Mass Index
Biopsy
Neoplasms
Prostate
Digital Rectal Examination
Obesity
Prostate-Specific Antigen
Linear Models
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Urology

Cite this

Body mass index as a predictor of prostate cancer : Development versus detection on biopsy. / Freedland, Stephen J.; Terris, Martha K.; Platz, Elizabeth A.; Presti, Joseph C.

In: Urology, Vol. 66, No. 1, 01.07.2005, p. 108-113.

Research output: Contribution to journalArticle

Freedland, Stephen J. ; Terris, Martha K. ; Platz, Elizabeth A. ; Presti, Joseph C. / Body mass index as a predictor of prostate cancer : Development versus detection on biopsy. In: Urology. 2005 ; Vol. 66, No. 1. pp. 108-113.
@article{a40770a523814caf8d8ad8f3784f8ee0,
title = "Body mass index as a predictor of prostate cancer: Development versus detection on biopsy",
abstract = "Objectives. To determine whether obesity is biologically associated with an increased risk of prostate cancer development, especially aggressive disease and to explore whether a bias may exist in our ability to detect these cancers in obese patients. Methods. We evaluated the association of body mass index (BMI) with prostate cancer, biopsy Gleason sum, and amount of cancer using logistic and linear regression analyses adjusting for age at biopsy, race, prostate-specific antigen level, digital rectal examination findings, and prostate volume among 787 consecutive men undergoing prostate biopsy between 1998 and 2002 at an equal-access medical center. Results. Men with a higher BMI were younger (P <0.001), had lower prostate-specific antigen concentrations (P = 0.02), fewer abnormal digital rectal examination findings (P = 0.02), and larger prostate volumes (P <0.001). After adjusting for age, no overall association was found between BMI and the odds of being diagnosed with cancer (P trend = 0.89), although overweight and mild obesity were inversely associated with the diagnosis of cancer. After multivariable adjustment, a higher BMI was associated with an increased odds of being diagnosed with prostate cancer (P trend = 0.007). Among men diagnosed with cancer, and after multivariable adjustment, a higher BMI was associated with a similar percentage of biopsy tissue with cancer (P trend = 0.23), but with greater odds of a high Gleason sum (P trend = 0.004). Conclusions. After taking into account the clinical characteristics that influence the likelihood of finding an existent cancer, a higher BMI was positively associated with being diagnosed with prostate cancer. Also, among the men with cancer, a higher BMI increased the odds of high-grade disease. These findings suggest that obesity may be biologically associated with prostate cancer development and, in particular, with high-grade disease.",
author = "Freedland, {Stephen J.} and Terris, {Martha K.} and Platz, {Elizabeth A.} and Presti, {Joseph C.}",
year = "2005",
month = "7",
day = "1",
doi = "10.1016/j.urology.2005.01.060",
language = "English (US)",
volume = "66",
pages = "108--113",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Body mass index as a predictor of prostate cancer

T2 - Development versus detection on biopsy

AU - Freedland, Stephen J.

AU - Terris, Martha K.

AU - Platz, Elizabeth A.

AU - Presti, Joseph C.

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Objectives. To determine whether obesity is biologically associated with an increased risk of prostate cancer development, especially aggressive disease and to explore whether a bias may exist in our ability to detect these cancers in obese patients. Methods. We evaluated the association of body mass index (BMI) with prostate cancer, biopsy Gleason sum, and amount of cancer using logistic and linear regression analyses adjusting for age at biopsy, race, prostate-specific antigen level, digital rectal examination findings, and prostate volume among 787 consecutive men undergoing prostate biopsy between 1998 and 2002 at an equal-access medical center. Results. Men with a higher BMI were younger (P <0.001), had lower prostate-specific antigen concentrations (P = 0.02), fewer abnormal digital rectal examination findings (P = 0.02), and larger prostate volumes (P <0.001). After adjusting for age, no overall association was found between BMI and the odds of being diagnosed with cancer (P trend = 0.89), although overweight and mild obesity were inversely associated with the diagnosis of cancer. After multivariable adjustment, a higher BMI was associated with an increased odds of being diagnosed with prostate cancer (P trend = 0.007). Among men diagnosed with cancer, and after multivariable adjustment, a higher BMI was associated with a similar percentage of biopsy tissue with cancer (P trend = 0.23), but with greater odds of a high Gleason sum (P trend = 0.004). Conclusions. After taking into account the clinical characteristics that influence the likelihood of finding an existent cancer, a higher BMI was positively associated with being diagnosed with prostate cancer. Also, among the men with cancer, a higher BMI increased the odds of high-grade disease. These findings suggest that obesity may be biologically associated with prostate cancer development and, in particular, with high-grade disease.

AB - Objectives. To determine whether obesity is biologically associated with an increased risk of prostate cancer development, especially aggressive disease and to explore whether a bias may exist in our ability to detect these cancers in obese patients. Methods. We evaluated the association of body mass index (BMI) with prostate cancer, biopsy Gleason sum, and amount of cancer using logistic and linear regression analyses adjusting for age at biopsy, race, prostate-specific antigen level, digital rectal examination findings, and prostate volume among 787 consecutive men undergoing prostate biopsy between 1998 and 2002 at an equal-access medical center. Results. Men with a higher BMI were younger (P <0.001), had lower prostate-specific antigen concentrations (P = 0.02), fewer abnormal digital rectal examination findings (P = 0.02), and larger prostate volumes (P <0.001). After adjusting for age, no overall association was found between BMI and the odds of being diagnosed with cancer (P trend = 0.89), although overweight and mild obesity were inversely associated with the diagnosis of cancer. After multivariable adjustment, a higher BMI was associated with an increased odds of being diagnosed with prostate cancer (P trend = 0.007). Among men diagnosed with cancer, and after multivariable adjustment, a higher BMI was associated with a similar percentage of biopsy tissue with cancer (P trend = 0.23), but with greater odds of a high Gleason sum (P trend = 0.004). Conclusions. After taking into account the clinical characteristics that influence the likelihood of finding an existent cancer, a higher BMI was positively associated with being diagnosed with prostate cancer. Also, among the men with cancer, a higher BMI increased the odds of high-grade disease. These findings suggest that obesity may be biologically associated with prostate cancer development and, in particular, with high-grade disease.

UR - http://www.scopus.com/inward/record.url?scp=22344442396&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22344442396&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2005.01.060

DO - 10.1016/j.urology.2005.01.060

M3 - Article

C2 - 15992911

AN - SCOPUS:22344442396

VL - 66

SP - 108

EP - 113

JO - Urology

JF - Urology

SN - 0090-4295

IS - 1

ER -