Obesity and prostate cancer screening, incidence, and mortality in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

• Published in: JNCI : Journal of the National Cancer Institute 2023-12, Vol.115 (12), p.1506-1514
• Main Authors: Hurwitz, Lauren M, Dogbe, Nadine, Barry, Kathryn Hughes, Koutros, Stella, Berndt, Sonja I
• Format: Article
• Language: English
• Subjects: Body Mass Index; Colorectal Neoplasms - complications; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Early Detection of Cancer - adverse effects; Humans; Incidence; Lung; Male; Obesity - complications; Obesity - epidemiology; Ovarian Neoplasms - complications; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - epidemiology; Prostate; Prostate-Specific Antigen; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology
• ISSN: 0027-8874; 1460-2105
• DOI: 10.1093/jnci/djad113

Though obesity, measured by body mass index (BMI), is an established risk factor for several cancer sites, there is conflicting evidence on whether obesity increases prostate cancer risk or mortality and, if it does, whether it increases risk directly or indirectly by affecting prostate cancer screening efficacy. We examined associations between BMI and prostate cancer screening outcomes, incidence, and mortality in men randomly assigned to the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (n = 36 756) between 1993 and 2001. Participants received annual screening with the prostate-specific antigen test and digital rectal exam. Associations between baseline BMI and screening outcomes were assessed via multinomial logistic regression, and associations with prostate cancer incidence and mortality were assessed via Cox proportional hazards regression. Individuals with higher BMI were less likely to screen positive via the prostate-specific antigen test and/or digital rectal exam and more likely to have an inadequate screen (all Ptrend