157 Obesity Increases the Risk for High-Grade Prostate Cancer: Results From the Reduce Study

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You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011157 OBESITY INCREASES THE RISK FOR HIGH-GRADE PROSTATE CANCER: RESULTS FROM THE REDUCE STUDY Stephen Freedland, Leah Gerber, Lionel L. Bañez, Daniel M. Moreira, Gerald L. Andriole, and Roger S. Rittmaster Stephen FreedlandStephen Freedland Durham, NC More articles by this author , Leah GerberLeah Gerber Durham, NC More articles by this author , Lionel L. BañezLionel L. Bañez Durham, NC More articles by this author , Daniel M. MoreiraDaniel M. Moreira New Hyde Park, NY More articles by this author , Gerald L. AndrioleGerald L. Andriole St. Louis, MO More articles by this author , and Roger S. RittmasterRoger S. Rittmaster Research Triangle Park, NC More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.225AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prior studies suggest obesity is associated with lower risk of prostate cancer (PC), though obesity is also associated with up to a 25% increased risk of PC mortality. How much of these associations result from lower PSA levels in obese men is unclear. We examined the influence of obesity on risk of low- and high-grade PC in the REDUCE study, where biopsies were largely independent of PSA. METHODS The 4-year REDUCE study tested dutasteride 0.5 mg daily for PC risk reduction in men with PSA of 2.5–10.0 ng/mL and a negative biopsy. Among men who underwent at least one on-study biopsy (n=6,729; 82.8%), the association between baseline body mass index (BMI; <25, 25–29.9, >=30.0 kg/m2) and risk of high-grade (Gleason >=7) or low-grade PC (Gleason <7) vs. no PC was examined using multinomial logistic regression adjusting for age, race, baseline PSA, prostate volume, rectal examination findings and treatment arm (dutasteride vs. placebo). As PC risks were similar in men with a BMI <25 and 25–29.9, we combined these two groups and analyzed BMI as <30 vs. >=30 kg/m2. We tested whether results differed by treatment arm using a test of interaction. RESULTS Overall, 1,762 men (27%) were normal weight, 3,429 (53%) overweight, and 1,333 (20%) were obese. Higher BMI was associated with lower PSA (p=0.03), but larger prostate volume (p=0.001) and younger age (p=0.001). After adjusting for age and prostate volume, both overweight (p=0.003) and obesity (p=0.013) were associated with lower PSA levels. On both univariate and multivariate analysis, overweight was not related to low- or high-grade PC (all p>0.18) and thus, BMI was dichotomized as <30 vs. >=30 kg/m2. On univariate analysis (RRR 0.74, 95% CI 0.62–0.89, p=0.001) and multivariate analysis (RRR 0.79, 95% CI 0.65–0.94, p=0.01) obesity was associated with lower risk of low-grade PC. On univariate analysis, obesity was not associated with high-grade PC (RRR 1.08, 95% CI 0.86–1.37, p=0.50). However, on multivariate analysis, obesity was associated with a significantly increased risk of high-grade PC (RRR 1.28, 95% CI 1.01–1.63, p=0.042). Results were similar for men on placebo or dutasteride (all p-interactions>0.40). CONCLUSIONS Obesity is associated with decreased risk of low-grade and increased risk of high-grade PC, which cannot simply be explained by differential biopsy rates due to differences in PSA. These data provide further support to the hypothesis that obesity is associated with aggressive PC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e66 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen Freedland Durham, NC More articles by this author Leah Gerber Durham, NC More articles by this author Lionel L. Bañez Durham, NC More articles by this author Daniel M. Moreira New Hyde Park, NY More articles by this author Gerald L. Andriole St. Louis, MO More articles by this author Roger S. Rittmaster Research Triangle Park, NC More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...