Relationship of prostate cancer with overweight and obesity (Bulgaria, 2022-2023)

Abstract Background Obesity and prostate cancer (PCa) are of serious public health interest. They both affect substantial number of people worldwide with a prognosis of increase. There is reliable evidence that obesity as modifiable risk factor relates to PCa. We aimed to analyse the relation of overweight and obesity with PCa and Benign Prostate Hyperplasia (BPH). Methods In a prospective “case-control” clinical study we analyse the impact of body mass index (BMI) on PCa. A sample of 135 men in 3 equal groups was selected: 45 patients with PCa, 45 BPH patients and 45 healthy men visiting clinic for prophylactic check-up, matched by age with PCa patients. WHO scale of BMI was used: underweight (<18.5 kg/m2); normal weight (18.5-24.99 kg/m2); overweight (25.0-29.99 kg/m2); and obesity (≥30.0 kg/m2). The groups were compared by parametric (t-test, univariate ANOVA) and non-parametric tests (chi-square, Cramer's V). The accepted significance level was p < 0.05. Data processing was performed by IBM SPSS Statistics v.25. Results There were no significant differences in age distribution (chi-square=5.026; df = 6; p = 0.540) and mean age in the study groups. The mean age of PCa patients was 69.87±6.233, in healthy controls 69.44±6.621 and in BPH patients 70.47±7.322 (F = 0.301; p = 0.741). There were no underweight subjects in the sample. The highest mean BMI was in PCa patients (27.653±2.359), followed by BPH patients (26.770±4.197), and healthy controls (24,647±2,235) - p < 0.05. The proportion of overweight was 80% in the PCa, 48.9% in BPH, and 53.4% in controls. Of the PCa patients, 13.3% were obese compared to 8.9% in BPH and only 2.2% in controls. The differences were highly significant (chi-square=20.650; df = 4; Cramer's V = 0.277; p = 0.000). Conclusions Our data support the association of prostate cancer with overweight and obesity. Overweight as a pre-step to obesity should attract greater attention in prophylactic check-ups to timely correct this risk factor through healthy lifestyle. Key messages • Much attention should be paid not only to obesity but also to overweight as a risk factor for the development of PCa. Healthy lifestyle is of utmost importance to reduce the risk of PCa and BPH. • Though the mechanism of association between obesity and PCa is not clear enough, health care providers should not neglect overweight and obese men in prophylactics for early diagnosis of PCa and BPH.