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BACKGROUND: Previous studies of prostate cancer (PCa) risk and anthropometrics (ie, body measurements) were based on single measurements or obtained over limited time spans. OBJECTIVE: To study the association between anthropometrics measured at multiple time points in life and their relation to later diagnosis, metastasis, or death from PCa. DESIGN, SETTING, AND PARTICIPANTS: This case-control study includes 27 167 Swedish men enrolled in two population-based projects from 1974 to 1996. PCa diagnosis up to December 31, 2006, disease information, gestation time, and anthropometrics at birth, military conscript testing, and adulthood were collected. A total of 1355 PCa cases were matched with 5271 controls. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariate conditional logistic regression was used to determine whether clinical diagnosis, metastasis, or PCa death was associated with low birth weight (weight <2500 g); with small size for gestational age; or with weight, length, or body mass index (BMI) at birth, adolescence (aged 16-22 yr), or early middle age (aged 44-50 yr). RESULTS AND LIMITATIONS: Apart from weight at adolescence, which was associated with an increased risk of PCa diagnosis (odds ratio [OR] per 5 kg: 1.05; 95% confidence interval [CI], 1.01-1.09; p=0.026), preadulthood measurements were not associated with any PCa end point. Adulthood parameters were not associated with diagnosis. In contrast, weight and BMI at early middle age were significantly associated with metastasis (OR per 5 kg: 1.13; 95% CI, 1.06-1.20; p<0.0001, and OR: 1.09; 95% CI, 1.05-1.14; p<0.0001) and death (OR per 5 kg: 1.11 (95% CI, 1.03-1.19; p=0.005, and OR: 1.08; 95% CI, 1.03-1.13; p=0.003), respectively. It remains unclear whether these results apply to men of nonwhite origin, to populations with active PCa screening programs, or to countries without socialized health care. CONCLUSIONS: The analyses of these large data sets demonstrate that significant effects of body characteristics (with links to metabolic syndrome) measured at early middle age are associated with PCa disease severity, metastatic progression, and outcome. Conversely, measurements at birth and adolescence are not associated with PCa prevalence or outcome. PATIENT SUMMARY: Increased weight and body mass index in adults is associated with a higher risk of prostate cancer metastasis and death.

Original publication

DOI

10.1016/j.eururo.2015.03.017

Type

Journal article

Journal

Eur Urol

Publication Date

12/2015

Volume

68

Pages

1076 - 1082

Keywords

Exposure windows, Long-term risk predictions, Metabolic syndrome–associated anthropometrics, Prostate cancer, Risk factors, Adolescent, Adult, Age Factors, Aged, Body Weights and Measures, Case-Control Studies, Humans, Infant, Newborn, Male, Middle Aged, Neoplasm Metastasis, Prostatic Neoplasms, Retrospective Studies, Young Adult