Childhood height increases the risk of prostate cancer mortality

Abstract

Background Adult body size is positively associated with aggressive and fatal prostate cancers. It is unknown whether these associations originate in early life. Therefore, we investigated if childhood height, body mass index (BMI; kg/m2) and growth are associated with prostate cancer-specific mortality and survival. Methods Subjects were 125,208 men from Copenhagen School Health Records Register, born 1930–1969 with height and weight measurements at ages 7–13 years. Linkage to the Danish Cancer Registry and the Register of Causes of Death enabled identification of incident and fatal prostate cancers. Cox proportional hazards regressions were performed. Results 630 men had prostate cancer recorded as the underlying cause of death. Childhood height at age 13 years was positively associated with prostate cancer-specific mortality (hazard ratio [HR]=1.2, 95% confidence interval [CI]: 1.1–1.3. Associations were significant at all other childhood ages. Growth analyses showed that height at age 13 years had a stronger association with prostate cancer-specific mortality than height at age 7, suggesting the association at age 7 is largely mediated through later childhood height. The tallest boys at age 13 years had a significantly worse survival, but only when restricted to a diagnosis at <60 years of age (HRz-score 1=1.7, 95% CI: 1.3–2.4). These associations were significant at all other childhood ages. Childhood BMI was not associated with prostate cancer mortality or survival. Conclusion Childhood height was positively associated with the hard endpoint of prostate cancer-specific mortality, which strengthens prior epidemiologic observations of a positive association with prostate cancer incidence.

Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study

“…These foods and nutrients may possibly increase PCa risk by several potential mechanisms, including suppression of 25(OH) vitamin D conversion to 1,25(OH)2 vitamin D, a molecule shown to increase cellular proliferation and reduce cellular differentiation in vitro, as well as elevation of insulin-like growth factor 1 (IGF-1) levels [26]. This latter mechanism is particularly relevant for adolescence because increased IGF-1 levels may alter the timing of onset and speed of puberty [27], as well as attained height [28], all of which are suspected or established PCa risk factors [29][30][31][32][33]. Consistent with this hypothesis, positive associations have been observed for early-life dairy product intake with adolescent height, height growth, and attained height in the small number of studies conducted [34][35][36][37][38].…”

Childhood diet and growth in boys in relation to timing of puberty and adult height: the Longitudinal Studies of Child Health and Development

“…One such strategy, which has been used successfully for breast cancer, is to study early-life exposures in relation to disease risk factors (e.g., earlier menarche) rather than in relation to the disease itself (e.g., breast cancer) (18). Although conclusive risk factors have not yet been identified for PCa, findings from recent studies of puberty using more accurate measures than in the past – i.e., measured height at age 13 (19, 20) and genetic markers of pubertal timing (21) – suggest that earlier timing of puberty may increase PCa risk/mortality. In addition, greater adult height has been found consistently to be associated with elevated PCa risk/mortality (22, 23), and thus may be a further useful tool for studying early-life exposures, as it can be measured well before PCa diagnosis.…”

Early-Life Alcohol Intake and High-Grade Prostate Cancer: Results from an Equal-Access, Racially Diverse Biopsy Cohort

“…Breslow and colleagues reported a significant inverse association between heavy drinking at ages 25, 35, and 45 and prostate cancer risk (20), with the inverse direction of association potentially attributable to detection bias due to lower screening rates among heavy drinkers and/or competing causes of death in this group. Although relatively few studies have investigated early-life exposure to alcohol, childhood height and early-life BMI have both been associated with increased risk of fatal prostate cancer (21,22), suggesting that early-life exposures may be important to consider in prostate carcinogenesis. Whether associations between early-life exposures and prostate cancer are due to specific windows of susceptibility, higher cumulative lifetime exposure, or changing patterns of behavior close to prostate cancer diagnosis, is unclear (5,11).…”