Body size and risk of prostate cancer in Jamaican men

Abstract

We investigated the associations between body size and risk of prostate cancer in a hospital-based case-control study in Jamaica. Height, weight, waist, and hip circumference were measured at enrollment, and data collected on medical and lifestyle factors for newly diagnosed cases (n = 243) and controls (n = 275). Compared with men in the normal range of waist-hip ratio (WHR), men with WHR > or =0.95 were at greater risk of total prostate cancer (OR,1.72; CI, 1.01-3.00) and high-grade cancer (OR, 2.02; CI, 1.03-3.96). With additional control for BMI, the association with WHR remained significant for total prostate cancer (OR, 1.90; CI, 1.01-3.53) and high-grade disease (OR, 2.94; CI, 1.34-6.38). There was no association between waist circumference and cancer without control for BMI but after controlling for BMI, waist circumference >90 cm (OR, 2.45; CI, 1.01-5.94) and >102 cm (OR, 5.57; CI, 1.43-18.63) showed a dose-response relationship with high-grade disease. Height and BMI were not associated with risk of prostate cancer. Abdominal obesity may be associated with risk of high-grade prostate cancer. Risk may be greater in those with higher abdominal obesity relative to overall size. The results further highlight the importance of investigating relationships by characteristics of the tumor.

Central Adiposity and Prostate Cancer in a Black Population

“…Those in the highest quartile of waist circumference (!108 cm) with a family history had a 2-fold increased risk of disease compared with those with waist circumference <0.95 (OR, 2.12; 95% CI, 1.10-4.11), whereas men without such history were not found to be at elevated risk. Two additional studies reported the association only among cases with aggressive or advanced disease (16,17), whereas a third investigation reported that higher waist circumference was associated with increased risk only after adjustment for BMI (11).…”

“…Several studies have indicated that WHR does not influence the development of prostate cancer (8, 9, 15, 16, 19 22, 23, 24), whereas others report a significant positive association (11,13,17,21). Although some investigations support the relationship between higher WHR measurements and increased prostate cancer risk regardless of disease severity, the association has been shown to be stronger among those with advanced, high-grade disease (13,17).…”

“…Although the majority of studies to date have been conducted in primarily European-derived populations, one additional study assessed the relationship between WHR and prostate cancer risk in a population of primarily African descent. The hospital-based case-control study conducted by Jackson and colleagues (11) found that Jamaican men with WHR ! 0.95 had a 2-fold increased risk of high-grade disease compared with men in the reference range of WHR (OR, 2.02; 95% CI, 1.03-3.96) and a significant association between WHR and prostate cancer was reported among all cases, regardless of disease grade (OR, 1.72; 95% CI, 1.01-3.00).…”

“…Fewer investigations have included measures of central adiposity, however, and only a limited number have been conducted in populations of African origin. The findings from these studies have been inconsistent, with higher waist circumference implicated as increasing total prostate cancer risk in one study of African-American men in Michigan (12) but not another including men from Jamaica (11). The Jamaican study, however, reported that larger WHRs increased risk among high grade and all prostate cancer cases, whereas race-stratified data from a study in North Carolina did not corroborate these findings (13).…”

“…As such, measurements of visceral fat, which may be more closely linked to metabolic changes, may serve as better predictors of prostate cancer development. Similarly, indicators of central fat distribution such as waist circumference, hip circumference, and waist-hip ratio (WHR) may be more appropriate than BMI for evaluating the potential relationship between body size and prostate cancer (11). Fewer investigations have included measures of central adiposity, however, and only a limited number have been conducted in populations of African origin.…”