Table 2.
Cox proportional hazard ratios and 95% confidence intervals for the linear association between adiposity and all-cause and prostate cancer–specific mortality (complete case analyses—main model)
| No. of events/total No. of men with prostate cancer | Hazard ratio a (95% CI) | P nonlinearity b | |
|---|---|---|---|
| Main analyses | |||
| BMI (per 5 kg/m2) | |||
| All-cause mortality | |||
| Prediagnosis or postdiagnosis combined | 320/942 | 1.30 (1.11 to 1.52) | .93 |
| Prediagnosis | 194/570 | 1.35 (1.11 to 1.65) | .71 |
| Postdiagnosis | 126/372 | 1.23 (0.91 to 1.66) | .48 |
| Prostate cancer–specific mortality | |||
| Prediagnosis or postdiagnosis combined | 163/942 | 1.49 (1.21 to 1.84) | .11 |
| Prediagnosis | 100/570 | 1.51 (1.16 to 1.96) | .61 |
| Postdiagnosis | 63/372 | 1.74 (1.13 to 2.68) | .04 |
| Waist circumference (per 10 cm) | |||
| All-cause mortality | |||
| Prediagnosis or postdiagnosis combined | 120/362 | 1.16 (0.97 to 1.39) | .03 |
| Prediagnosis | 86/245 | 1.31 (1.07 to 1.61) | .06 |
| Postdiagnosis | 34/117 | 0.67 (0.40 to 1.08) | .72 |
| Prostate cancer–specific mortality | |||
| Prediagnosis or postdiagnosis combined | 79/362 | 1.26 (1.01 to 1.57) | .03 |
| Prediagnosis | 53/245 | 1.47 (1.14 to 1.89) | .01 |
| Postdiagnosis | 26/117 | 0.79 (0.46 to 1.37) | .79 |
| Hip circumference (per 10 cm) | |||
| All-cause mortality | |||
| Prediagnosis or postdiagnosis combined | 45/167 | 1.12 (0.72 to 1.77) | .88 |
| Prediagnosis | 42/128 | 1.19 (0.74 to 1.91) | .74 |
| Postdiagnosis | 3/39 | (Limited data) | —c |
| Prostate cancer–specific mortality | |||
| Prediagnosis or postdiagnosis combined | 23/167 | 1.48 (0.80 to 2.74) | .29 |
| Prediagnosis | 21/128 | 1.88 (0.94 to 3.77) | .62 |
| Postdiagnosis | 2/39 | (Limited data) | —c |
| Waist to hip ratio (per 0.1 unit) | |||
| All-cause mortality | |||
| Prediagnosis or postdiagnosis combined | 45/167 | 1.18 (0.70 to 1.99) | .47 |
| Prediagnosis | 42/128 | 1.24 (0.71 to 2.15) | .91 |
| Postdiagnosis | 3/39 | (Limited data) | —c |
| Prostate cancer–specific mortality | |||
| Prediagnosis or postdiagnosis combined | 23/167 | 1.47 (0.67 to 1.02) | .50 |
| Prediagnosis | 21/128 | 1.71 (0.67 to 4.34) | .75 |
| Postdiagnosis | 2/39 | (Limited data) | —c |
| Subgroup and sensitivity analyses | |||
| Prediagnosis or postdiagnosis BMI combined, per 5 kg/m2 | |||
| Disease staged | |||
| All-cause mortality | |||
| Localized | 175/656 | 1.17 (0.92 to 1.49) | .19 |
| Advanced (includes metastatic) | 145/286 | 1.38 (1.09 to 1.73) | .37 |
| All, excluding metastatic | 233/819 | 1.25 (1.02 to 1.52) | .26 |
| Only metastatic | 87/123 | 1.37 (1.00 to 1.86) | .19 |
| Prostate cancer–specific mortality | |||
| Localized | 61/656 | 1.45 (1.01 to 2.08) | .13 |
| Advanced (includes metastatic) | 102/286 | 1.52 (1.15 to 2.02) | .39 |
| All, excluding metastatic | 85/819 | 1.57 (1.16 to 2.13) | .23 |
| Only metastatic | 78/123 | 1.35 (0.97 to 1.87) | .43 |
| Tumor gradee | |||
| All-cause mortality | |||
| Well differentiated—Gleason score 2-6 | 106/427 | 1.34 (1.02 to 1.72) | .85 |
| Moderately differentiated—Gleason score 7 | 118/359 | 1.20 (0.89 to 1.62) | .12 |
| Poorly differentiated—Gleason score 8-10 | 96/156 | 1.21 (0.88 to 1.65) | .22 |
| Prostate cancer–specific mortality | |||
| Well differentiated—Gleason score 2-6 | 34/427 | 1.49 (0.99 to 2.27) | .12 |
| Moderately differentiated—Gleason score 7 | 59/359 | 1.33 (0.89 to 1.99) | .71 |
| Poorly differentiated—Gleason score 8-10 | 70/156 | 1.51 (1.06 to 2.16) | .19 |
| Additional adjustment for baseline highest school level (proxy for socioeconomic status) | |||
| All-cause mortality | 318/936 | 1.25 (1.06 to 1.47) | .65 |
| Prostate cancer–specific mortality | 163/936 | 1.43 (1.15 to 1.77) | .07 |
| Lagged analysis—removing deaths during the first year of follow-up | |||
| All-cause mortality | 308/930 | 1.34 (1.14 to 1.58) | .90 |
| Prostate cancer–specific mortality | 155/930 | 1.54 (1.25 to 1.91) | .10 |
| Postdiagnosis BMI analyses, per 5 kg/m2 | |||
| Lagged analysis—removing deaths during the first year of follow-up | |||
| All-cause mortality | 117/363 | 1.34 (0.98 to 1.83) | .44 |
| Prostate cancer–specific mortality | 57/363 | 1.96 (1.24 to 3.08) | .04 |
| Additional adjustment for prediagnosis/baseline BMI | |||
| All-cause mortality | 126/372 | 1.04 (0.55 to 1.99) | .46 |
| Prostate cancer–specific mortality | 63/372 | 1.49 (0.61 to 3.67) | .03 |
| By each year of BMI measurement (up to 2 y before diagnosis and up to 5 y after diagnosis), per 5 kg/m2 | |||
| First year before diagnosis | |||
| All-cause mortality | 78/239 | 1.07 (0.76 to 1.50) | .52 |
| Prostate cancer–specific mortality | 37/239 | 1.51 (0.91 to 2.50) | .79 |
| Second year before diagnosis | |||
| All-cause mortality | 116/331 | 1.59 (1.24 to 2.04) | .80 |
| Prostate cancer–specific mortality | 63/331 | 1.54 (1.11 to 2.15) | .71 |
| First year after diagnosis | |||
| All-cause mortality | 52/146 | 1.44 (0.84 to 2.46) | .68 |
| Prostate cancer–specific mortality | 30/146 | 1.84 (0.90 to 3.74) | .03 |
| Second year after diagnosis | |||
| All-cause mortality | 40/123 | 1.58 (0.90 to 2.76) | .42 |
| Prostate cancer–specific mortality | 20/123 | 2.09 (0.95 to 4.58) | .93 |
| Third year after diagnosis | |||
| All-cause mortality | 26/77 | 1.05 (0.52 to 2.13) | .67 |
| Prostate cancer–specific mortality | 10/77 | 1.91 (0.49 to 7.47) | .91 |
a
Main model (model 3) hazard ratio adjusted for age, year of diagnosis, disease stage, tumor grade, and smoking status and stratified by EPIC country. BMI = body mass index; CI = confidence interval; EPIC = European Prospective Investigation into Cancer and Nutrition.
b
Analysis of variance test of models with the restricted cubic spline term compared with models with the linear term (without the spline term).
c
No available data.
d
Not adjusted for disease stage apart from the analysis that excludes men with metastatic prostate cancer.
e
Not adjusted for tumor grade.