Abstract
Substantial evidence links higher adiposity to prostate cancer development. The relationship between adiposity and outcomes after a prostate cancer diagnosis, however, is unclear. This study aimed to investigate the association between adiposity measured close to prostate cancer diagnosis and all-cause and prostate cancer-specific mortality in a prospective cohort study. Cox regression analyses estimated HRs and 95% confidence intervals (CI) for mortality in 3,760 men in the UK Biobank who had first primary prostate cancer and complete data on body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio (measured up to 2 years before or up to 5 years after diagnosis), and on covariates (diagnosis age and year, smoking, Townsend deprivation index, exercise, sedentary activities, and alcohol). The waist-to-height ratio and body fat percentage (assessed by bioelectrical impedance) were also evaluated as adiposity measures. Each 5-U increment in pre- or post-diagnosis BMI (N = 3,760) was associated with a 30% (95% CI, 1.18-1.44) higher rate of all-cause mortality (deaths = 680), a 33% (95% CI, 1.15-1.52) higher rate of prostate cancer-specific mortality (deaths = 331), and a 28% (95% CI, 1.12-1.47) higher rate of non-prostate cancer mortality (deaths = 347). Positive associations of similar magnitude were observed for separate analyses by pre- and post-diagnosis BMI and for waist and hip circumference, waist-to-hip ratio, waist-to-height ratio, and body fat percentage. Obesity assessed close to prostate cancer diagnosis is associated with higher mortality. More studies are needed to strengthen the evidence and clarify the mechanisms behind the observed associations. SIGNIFICANCE: Patients with prostate cancer might improve their chances of survival by avoiding obesity.