Freedland SJ. - 44370 N - JAMA Intern Med 2013 ; in press.
There are 3 well-established risk factors for prostate cancer: race (specifically, African American race), family history, and age. Unfortunately, we cannot change our race or our parents nor can we stop time. Given this reality, there is much interest in identifying modifiable risk factors for prostate cancer. In a landmark study, Calle and colleagues followed up more than 900 000 persons for more than 16 years and found that obesity was linked with death from 17 different cancer types.1 Although prostate cancer was one of the cancers identified, its association with obesity was modest, with mildly obese (body mass index [calculated as weight in kilograms divided by height in meters squared], 30-34.9) and moderately obese (body mass index, 35-39.9) men being 20% and 34% more likely, respectively, to die of prostate cancer. Even so, given the large number of men who die annually of prostate cancer (258 100 worldwide and 32 600 in North America in 2008)2 and the high prevalence of obesity (35% in the United States in 2012),3 the association means that tens of thousands of men die annually of obesity-related prostate cancer. While the exact links between obesity and prostate cancer are complex, diet and lifestyle invariably play a role.