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    How do height, adiposity affect prostate Ca risk?

    Men who are taller and those with greater adiposity are at increased risk of having high-grade prostate cancer and of dying from their malignancy, according to new analyses of data collected in the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

    As reported in a study published in BMC Medicine (2017; 15:115), the investigators analyzed data from 141,896 men enrolled in EPIC, a multicenter cohort study investigating relationships between diet, lifestyle, environmental factors, and cancer risk. Within this population, 7,024 men developed prostate cancer during a mean follow-up of almost 14 years and 934 men died from their prostate cancer.

    Multivariable-adjusted models were used to examine associations between height, body mass index (BMI), and waist circumference with prostate cancer risk and death. The prostate cancer risk analyses considered incidence of total prostate cancer and also examined associations with disease aggressiveness by categorizing prostate cancer based on grade (low-intermediate and high) and stage (localized and advanced). For each of the main exposure variables (height, BMI, waist circumference), the men were divided into fifths, and hazard ratios (HRs) were calculated, using the lowest fifth as the reference group.

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    Statistically significant positive associations were found between height and both high-grade disease and prostate cancer death. Statistically significant associations between the measures of adiposity and prostate cancer varied by disease aggressiveness. Both BMI and waist circumference were significantly inversely associated with total prostate cancer, low-grade disease, and localized disease, but they were positively associated with high-grade prostate cancer, advanced prostate cancer, and prostate cancer death.

    Men in the highest fifth for height had a 1.54-fold increased risk for having high-grade prostate cancer and a 1.43-fold increased risk for prostate cancer death compared with the shortest subgroup. Waist circumference, which may be considered a better marker than BMI for adiposity in men, had slightly stronger associations with the aggressiveness and mortality endpoints than BMI. Men in the highest fifth for waist circumference had a 1.43-fold increased risk for having high-grade prostate cancer and a 1.55-fold increased risk for prostate cancer-related mortality compared with the reference group.

    Next: "Further research is still needed to understand possible mechanisms"

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