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Public release date: 27 October 2008
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Prostate Cancer Mortality Is Higher For Overweight Men
Researchers from Brigham and Women's Hospital (BWH) and colleagues found
that excess bodyweight and high plasma concentrations of C-peptide (a
protein that reflects the amount of insulin secretion) in men who are
subsequently diagnosed with prostate cancer are reliable indicators that
they are more likely to die from their disease than those with lower levels.
This substudy of the Physician's Health Study is found in an article
published in the November edition of The Lancet Oncology.
Jing Ma, MD, MPH, PhD, of the Department of Epidimiology at BWH, and
colleagues assessed data from 2546 men diagnosed with prostate cancer during
24 years of follow-up in the Physician's Health Study. The association
between baseline BMI, baseline plasma C-peptide concentrations, and BMI
measured at 8-years of follow-up and subsequent prostate cancer-related
death was examined.
Several past studies have suggested that men who are overweight, as measured
by body-mass index (BMI), have an increased risk of prostate-cancer
progression and disease-related death. However, long-term, prospective data
on prostate cancer-specific mortality have been scarce. Furthermore,
although the high insulin concentrations associated with obesity could
potentially explain the adverse effect of obesity on prostate cancer
mortality, no studies had assessed the association between pre-diagnostic
plasma concentrations of C-peptide and prostate cancer-specific mortality.
Using the Physician's Health Study, researchers found that men who were
overweight (BMI =25-29·9 kg/m2) or obese (BMI =30 kg/m2) before diagnosis
were significantly more likely to die from their prostate cancer than men of
normal weight (BMI <25 kg/m2). This trend remained significant after
controlling for clinical stage and Gleason grade. Baseline C-peptide
concentrations were available for 827 men and those with the highest
C-peptide plasma concentrations also had a higher risk of prostate-cancer
mortality compared with men with the lowest concentrations. Men with both a
high C-peptide concentration and high BMI prior to diagnosis of prostate
cancer had a four times higher risk of disease-specific mortality,
independent of other clinical predictors.
The findings provide "further impetus for men to avoid becoming overweight
and to decrease their risk of metabolic syndrome by physical activity and
diet; and also adds to the rationale for investigation of new therapeutics
and prevention strategies, such as use of insulin-lowering or anti-diabetic
drugs," says Dr Ma.
Researchers also note that measurement of a blood hormone level, even prior
to the diagnosis of a cancer, allows one to predict the behavior of cancer
that might arise many years in the future.
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