Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study

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Title: Tall height and obesity are associated with an increased risk of aggressive prostate cancer: results from the EPIC cohort study
Authors: Perez-Cornago, A
Appleby, PN
Pischon, T
Tsilidis, KK
Tjonneland, A
Olsen, A
Overvad, K
Kaaks, R
Kuhn, T
Boeing, H
Steffen, A
Trichopoulou, A
Lagiou, P
Kritikou, M
Krogh, V
Palli, D
Sacerdote, C
Tumino, R
Bueno-de-Mesquita, HB
Agudo, A
Larranaga, N
Molina-Portillo, E
Barricarte, A
Chirlaque, MD
Ramon Quiros, J
Stattin, P
Haggstrom, C
Wareham, N
Khaw, KT
Schmidt, JA
Gunter, M
Freisling, H
Aune, D
Ward, H
Riboli, E
Key, TJ
Travis, RC
Item Type: Journal Article
Abstract: Background The relationship between body size and prostate cancer risk, and in particular risk by tumour characteristics, is not clear because most studies have not differentiated between high-grade or advanced stage tumours, but rather have assessed risk with a combined category of aggressive disease. We investigated the association of height and adiposity with incidence of and death from prostate cancer in 141,896 men in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods Multivariable-adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average of 13.9 years of follow-up, there were 7024 incident prostate cancers and 934 prostate cancer deaths. Results Height was not associated with total prostate cancer risk. Subgroup analyses showed heterogeneity in the association with height by tumour grade (P heterogeneity = 0.002), with a positive association with risk for high-grade but not low-intermediate-grade disease (HR for high-grade disease tallest versus shortest fifth of height, 1.54; 95% CI, 1.18–2.03). Greater height was also associated with a higher risk for prostate cancer death (HR = 1.43, 1.14–1.80). Body mass index (BMI) was significantly inversely associated with total prostate cancer, but there was evidence of heterogeneity by tumour grade (P heterogeneity = 0.01; HR = 0.89, 0.79–0.99 for low-intermediate grade and HR = 1.32, 1.01–1.72 for high-grade prostate cancer) and stage (P heterogeneity = 0.01; HR = 0.86, 0.75–0.99 for localised stage and HR = 1.11, 0.92–1.33 for advanced stage). BMI was positively associated with prostate cancer death (HR = 1.35, 1.09–1.68). The results for waist circumference were generally similar to those for BMI, but the associations were slightly stronger for high-grade (HR = 1.43, 1.07–1.92) and fatal prostate cancer (HR = 1.55, 1.23–1.96). Conclusions The findings from this large prospective study show that men who are taller and who have greater adiposity have an elevated risk of high-grade prostate cancer and prostate cancer death.
Issue Date: 13-Jul-2017
Date of Acceptance: 16-May-2017
ISSN: 1741-7015
Publisher: BioMed Central
Journal / Book Title: BMC Medicine
Volume: 15
Copyright Statement: © The Author(s). 2017. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Imperial College Trust
Funder's Grant Number: P47328
Keywords: Adiposity
Cohort study
High grade
Prostate cancer
Tumour characteristics
General & Internal Medicine
11 Medical And Health Sciences
Publication Status: Published
Article Number: 115
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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