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Increase in obesity since 1980 has obscured U.S. prostate cancer mortality rates

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Since 1980 the obesity prevalence has steadily increased in the United States and has partially masked declines in prostate cancer mortality, according to data from an analysis.

“Current evidence indicates that trends in obesity have likely increased the incidence of high-grade prostate cancer over time, with a nontrivial effect on prostate cancer mortality through 2002,” the researchers wrote.

To establish how the increase in obesity has affected prostate cancer trends in the United States, researchers gathered data from the National Health and Nutritional Examination Survey on overweight and obesity prevalence rates. In addition, the researchers collected disease incidence, survival and mortality data from the Surveillance, Epidemiology and End Results program. All study participants were men aged 40 to 74 years.

The researchers also assessed the obesity-associated relative risks for low-and high-grade prostate cancer using data from the Prostate Cancer Prevention Trial.

Although associated with a nonsignificant decreased risk for low-grade prostate cancer, obesity (BMI ≥30) was associated with a 79% increased risk for high-grade prostate cancer.

The increase in obesity was estimated to have led to a 0.7% increase in age-adjusted all-grade incidence (95% CI, 3.2% decrease to 4.4% increase), a 1.3% decrease in age-adjusted low-grade incidence (95% CI, 4.9% decrease to 2.2% increase) and a 15.5% increase in age-adjusted high-grade incidence (95% CI, 3.9% increase to a 25.9% increase) during 2002.

Data further indicated that the prostate cancer mortality rate during 2002 was 23% higher from what was expected had the obesity rate remained steady at 1980 levels (95% CI, 15.8% higher to 29.3% higher).

“This analysis underscores the complexity of the determinants of prostate cancer incidence and mortality trends and shows that it is likely that these trends depend on factors beyond screening and treatment,” the researchers added.

Fesinmeyer M. Cancer Epidemiol Biomarkers Prev. 2009;18:808-815.