Abstract
The relationship between body mass index (BMI) and incidence of prostate cancer is still inconclusive. We performed a dose-response meta-analysis of eligible cohort studies to evaluate potential association of BMI with prostate cancer risk by subtype of prostate cancer (nonaggressive and aggressive). A comprehensive literature search was performed in PubMed and Web of Science databases through March 22, 2017. Linear and non-linear dose-response meta-analyses were carried out to evaluate the effects of BMI on incidence of prostate cancer. A total of 21 cohort or nested case-control studies (17 for nonaggressive and 21 for aggressive prostate cancer) were included in this meta-analysis. For nonaggressive prostate cancer, the pooled relative risk (RR) per 5 kg/m2 increment of BMI with 95% confidence interval (CI) was 0.96 (95% CI 0.92–1.00). Sensitivity analysis indicated that this result was not robust and steady. For aggressive prostate cancer, a significant linear direct relationship with BMI (RR, 1.07; 95% CI 1.03–1.12) for every 5 kg/m2 increase was observed. Statistically significant heterogeneity was detected for nonaggressive prostate cancer (P = 0.020, I2 = 46.1%) but not for aggressive prostate cancer (P = 0.174, I2 = 22.4%). In conclusion, BMI level may be positively associated with aggressive prostate cancer risk. Further large prospective cohort studies are warranted to confirm the findings from our study.
Highlights
Prostate cancer has become the most common malignancy in males in several developed countries and the second most common one worldwide after lung cancer [1]
The pooled relative risk (RR) per 5 kg/m2 increment of body mass index (BMI) with 95% confidence interval (CI) was 0.96
Significant heterogeneity was detected for nonaggressive prostate cancer (P = 0.020, I2 = 46.1%) but not for aggressive prostate cancer (P = 0.174, I2 = 22.4%)
Summary
Prostate cancer has become the most common malignancy in males in several developed countries and the second most common one worldwide after lung cancer [1]. A large number of well-designed prospective cohort studies have been performed to evaluate the potential relationship between body mass index (BMI) and prostate cancer risk with positive, negative, or null results. Several studies indicated that body adiposity may have a dual effect on two subtypes of prostate cancer (localized/ non-aggressive and advanced/aggressive cancer) [4, 5]. A high BMI appeared to increase the risk of advanced prostate cancer while reducing the risk of localized disease. These results support the hypothesis of a dual effect of BMI on prostate cancer carcinogenesis [6].
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