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      Body mass index trajectories and prostate cancer risk: Results from the EPICAP study

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          Abstract

          Elevated body mass index (BMI) has been inconsistently associated with prostate cancer occurrence but it has been suggested that life course adulthood obesity may be associated with an increased risk of prostate cancer. However, few studies have investigated lifetime BMI and prostate cancer risk. We analyzed life course BMI trajectories on prostate cancer risk based on data from the Epidemiological study of Prostate Cancer (EPICAP). We included in our analyses 781 incident prostate cancer cases and 829 controls frequency matched by age. Participants were asked about their weight every decade from age 20 to two years before reference date. BMI trajectories were determined using group‐based trajectory modeling to identify groups of men with similar patterns of BMI changes. We identified five BMI trajectories groups. Men with a normal BMI at age 20 developing overweight or obesity during adulthood were at increased risk of aggressive prostate cancer compared to men who maintained a normal BMI. Our results suggest that BMI trajectories resulting in overweight or obesity during adulthood are associated with an increased risk of aggressive prostate cancer, particularly in never smokers, emphasizing the importance of maintaining a healthy BMI throughout adulthood.

          Abstract

          The influence of body weight during lifetime on PCa risk remains largely ununderstood and has been poorly investigated. Our findings suggest that elevated BMI during adulthood resulting in overweight or obesity is associated with an increased risk of aggressive PCa, emphasizing the importance of maintaining a healthy BMI throughout adulthood.

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          Most cited references 27

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          Inflammation in prostate carcinogenesis.

          About 20% of all human cancers are caused by chronic infection or chronic inflammatory states. Recently, a new hypothesis has been proposed for prostate carcinogenesis. It proposes that exposure to environmental factors such as infectious agents and dietary carcinogens, and hormonal imbalances lead to injury of the prostate and to the development of chronic inflammation and regenerative 'risk factor' lesions, referred to as proliferative inflammatory atrophy (PIA). By developing new experimental animal models coupled with classical epidemiological studies, genetic epidemiological studies and molecular pathological approaches, we should be able to determine whether prostate cancer is driven by inflammation, and if so, to develop new strategies to prevent the disease.
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            The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas.

            Recent evidence indicates that obesity and related metabolic abnormalities are associated with increased incidence or mortality for a number of cancers, including those of the colon, prostate, and pancreas. Obesity, physical inactivity, visceral adiposity, hyperglycemia, and hyperinsulinemia are relatively consistent risk factors for colon cancer and adenoma. Also, patients with type 2 diabetes mellitus have a higher risk of colon cancer. For prostate cancer, the relationship to obesity appears more complex. Obesity seems to contribute to a greater risk of aggressive or fatal prostate cancer but perhaps to a lower risk of nonaggressive prostate cancer. Furthermore, men with type 2 diabetes mellitus are at lower risk of developing prostate cancer. Long-standing type 2 diabetes increases the risk of pancreatic cancer by approximately 50%. Furthermore, over the past 6 years, a large number of cohort studies have reported positive associations between obesity and pancreatic cancer. Together with data from prediagnostic blood specimens showing positive associations between glucose levels and pancreatic cancer up to 25 years later, sufficient evidence now supports a strong role for diabetes and obesity in pancreatic cancer etiology. The mechanisms for these associations, however, remain speculative and deserve further study. Hyperinsulinemia may be important, but the role of oxidative stress initiated by hyperglycemia also deserves further attention.
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              Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies.

              The relationship between obesity and risk of prostate cancer (PCa) is unclear; however, etiologic heterogeneity by subtype of PCa (localized, advanced) related to obesity was suggested. Therefore, we conducted a dose-response meta-analysis of prospective studies to assess the association between body mass index (BMI) and risk of localized and advanced PCa. Relevant prospective studies were identified by a search of Medline and Embase databases to 03 October 2011. Twelve studies on localized PCa (1,033,009 men, 19,130 cases) and 13 on advanced PCa (1,080,790 men, 7067 cases) were identified. We carried out a dose-response meta-analysis using random-effects model. For localized PCa, we observed an inverse linear relationship with BMI [Ptrend<0.001, relative risk (RR): 0.94 (95% confidence interval, 95% CI, 0.91-0.97) for every 5 kg/m2 increase]; there was no evidence of heterogeneity (Pheterogeneity=0.27). For advanced PCa, we observed a linear direct relationship with BMI (Ptrend=0.001, RR: 1.09 (95% CI 1.02-1.16) for every 5 kg/m2 increase); there was weak evidence of heterogeneity (Pheterogeneity=0.08). Omitting one study that contributed substantially to the heterogeneity yielded a pooled RR of 1.07 (95% CI 1.01-1.13) for every 5 kg/m2 increase (Pheterogeneity=0.26). The quantitative summary of the accumulated evidence indicates that obesity may have a dual effect on PCa-a decreased risk for localized PCa and an increased risk for advanced PCa.
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                Author and article information

                Contributors
                florence.menegaux@inserm.fr
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                08 July 2020
                September 2020
                : 9
                : 17 ( doiID: 10.1002/cam4.v9.17 )
                : 6421-6429
                Affiliations
                [ 1 ] Université Paris‐Saclay UVSQ Inserm CESP Villejuif France
                [ 2 ] Service Urologie Clinique Beau Soleil Montpellier France
                [ 3 ] Labosud Institut médical d’Analyse Génomique‐Imagenome Montpellier France
                [ 4 ] Registre des tumeurs de l'Hérault Montpellier France
                Author notes
                [* ] Correspondence

                Florence Menegaux, INSERM U1018‐CESP, Team Exposome, Heredity, Cancer and Health, 16 av. Paul Vaillant Couturier, 94807 Villejuif Cedex, France.

                Email: florence.menegaux@ 123456inserm.fr

                Article
                CAM43241
                10.1002/cam4.3241
                7476828
                32639678
                © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 1, Tables: 3, Pages: 9, Words: 6335
                Product
                Funding
                Funded by: Ligue nationale contre le cancer
                Funded by: Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail
                Funded by: Fondation de France , open-funder-registry 10.13039/501100004431;
                Funded by: Ligue départementale du Val de Marne
                Categories
                Original Research
                Cancer Prevention
                Original Research
                Custom metadata
                2.0
                September 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.9 mode:remove_FC converted:07.09.2020

                Oncology & Radiotherapy

                body mass index, obesity, prostate cancer, trajectory, weight gain

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