TY - JOUR
T1 - Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age
T2 - Data from the malmö preventive project
AU - Assel, Melissa J.
AU - Gerdtsson, Axel
AU - Thorek, Daniel L.J.
AU - Carlsson, Sigrid V.
AU - Malm, Johan
AU - Scardino, Peter T.
AU - Vickers, Andrew
AU - Lilja, Hans
AU - Ulmert, David
N1 - Funding Information:
David Ulmert was supported in part by the Knut and Alice Wallenberg Foundation, the Bertha Kamprad Foundation, and the David H. Koch Prostate Cancer Foundation Young Investigator Award (PCF-YIA). Daniel LJ Thorek was supported by the NIH NCI-1RO1CA201035 and the Steve Wynn PCF-YIA. Hans Lilja in part by the National Cancer Institute (R33 CA127768-02), Oxford Biomedical Research Centre Program in UK, Swedish Cancer Society (project no. 14-0722), and Swedish Research Council (VR-MH; project no. 2016-02974). David Ulmert, Peter T Scardino, Sigrid V Carlsson and Hans Lilja were supported in part by a Cancer Center Support Grant from the National Institutes of Health/National Cancer Institute (NIH/NCI) made to Memorial Sloan Kettering Cancer Center (P30 CA008748), the MSKCC SPORE in Prostate Cancer (P50 CA92629), the David H. Koch Fund of the PCF, and the Sidney Kimmel Center for Prostate and Urologic Cancers.
Publisher Copyright:
© Assel et al.
PY - 2018
Y1 - 2018
N2 - Objectives: To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results: After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods: In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Conclusions: Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multivariable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.
AB - Objectives: To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. Results: After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. Materials and Methods: In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Conclusions: Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multivariable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.
KW - BMI
KW - Obesity
KW - PSA
KW - Prostate cancer
KW - Weight
UR - http://www.scopus.com/inward/record.url?scp=85040661689&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.22981
DO - 10.18632/oncotarget.22981
M3 - Article
C2 - 29464033
AN - SCOPUS:85040661689
SN - 1949-2553
VL - 9
SP - 5778
EP - 5785
JO - Oncotarget
JF - Oncotarget
IS - 5
ER -