Overall and central obesity and prostate cancer risk in African men
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Springer
Abstract
Purpose African men are disproportionately affected by prostate cancer (PCa). Given the increasing prevalence of obesity
in Africa, and its association with aggressive PCa in other populations, we examined the relationship of overall and central
obesity with risks of total and aggressive PCa among African men.
Methods Between 2016 and 2020, we recruited 2,200 PCa cases and 1,985 age-matched controls into a multi-center,
hospital-based case–control study in Senegal, Ghana, Nigeria, and South Africa. Participants completed an epidemiologic
questionnaire, and anthropometric factors were measured at clinic visit. Multivariable logistic regression was used to examine
associations of overall and central obesity with PCa risk, measured by body mass index (BMI), waist circumference (WC),
waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), respectively.
Results Among controls 16.4% were obese (BMI≥30 kg/m2
), 26% and 90% had WC>97 cm and WHR>0.9, respectively.
Cases with aggressive PCa had lower BMI/obesity in comparison to both controls and cases with less aggressive PCa,
suggesting weight loss related to cancer. Overall obesity (odds ratio: OR = 1.38, 95% CI 0.99–1.93), and central obesity
(WC>97 cm: OR = 1.60, 95% CI 1.10–2.33; and WHtR>0.59: OR = 1.68, 95% CI 1.24–2.29) were positively associated
with D’Amico intermediate-risk PCa, but not with risks of total or high-risk PCa. Associations were more pronounced in
West versus South Africa, but these differences were not statistically significant.
Discussion The high prevalence of overall and central obesity in African men and their association with intermediate-risk
PCa represent an emerging public health concern in Africa. Large cohort studies are needed to better clarify the role of
obesity and PCa in various African populations.
Description
Research Article
Keywords
Prostate cancer, African men, Body mass index, Obesity, Central adiposity, Sub-Saharan Africa