Abstract
Background and ObjectivesIn previous studies, obesity (measured according to the body mass index) has correlated inconsistently with the risk of biopsy-measured prostate cancer, and specifically high-grade prostate cancer. This meta-analysis aimed to clarify these correlations.MethodsA comprehensive literature search of the MEDLINE and EMBASE databases was conducted for relevant studies published through January 2014. The pooled estimates of odds ratios (OR) and confidence intervals (CI) were computed, and the meta-analysis was performed with the STATA software according to a random effects approach.ResultsA total of 11 studies that included 29,464 individuals were identified. A 5-kg/m2 increase in body mass index was associated with a 15% (OR, 1.15; 95% CI, 0.98–1.34) higher risk of prostate cancer detection and a 37% (OR, 1.37; 95% CI, 1.19–1.57) higher risk of high-grade prostate cancer detection at biopsy. There were no differences among the results of studies conducted in the USA, Europe or Asia. We also found that studies that had adjusted for prostate-specific antigen levels, digital rectal examination results, and prostate volumes obtained positive significant outcomes (OR, 1.27; 95% CI, 1.12–1.44), whereas studies that did not adjust for the above-mentioned confounding variables obtained negative results (OR, 0.92; 95% CI, 0.68–1.25). Moreover, the positive correlation between body mass index and the detection of both prostate cancer and high-grade diseases tended to be stronger as the number of biopsy cores increased.ConclusionThe present meta-analysis demonstrated that a high body mass index correlated positively with prostate cancer detection, especially high-grade prostate cancer detection. The adoption of a modified and possibly more aggressive biopsy strategy was suggested for obese populations.
Highlights
Obesity, an increasing public health concern worldwide, has been linked to the development of various cancers [1]
Only clinical studies conducted in analytical epidemiological settings that offered direct comparisons between the body mass indices (BMI) and the risk of prostate cancer (PCa) or high-grade PCa (HGPCa) were incorporated into the analysis
The studies were adjusted for different potential confounders, including age, prostate-specific antigen (PSA) levels, digital rectal examination (DRE) findings, and prostate volumes (PV), among others
Summary
An increasing public health concern worldwide, has been linked to the development of various cancers [1]. This link has been further strengthened by fundamental research studies, in which scientists found that obesity could result in the generation of a unique endocrine and biochemical tumor growth-promoting microenvironment [2]. Obesity (measured according to the body mass index) has correlated inconsistently with the risk of biopsy-measured prostate cancer, and high-grade prostate cancer. This metaanalysis aimed to clarify these correlations
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