Waist circumference and a body shape index and prostate cancer risk and mortality.

We recently found a negative association between body mass index (BMI) and the risk of localised prostate cancer (PCa), no association with advanced PCa, and a positive association with PCa-specific mortality. In a 15% subpopulation of that study, we here investigated the measures of abdominal adiposity including waist circumference (WC) and A Body Shape Index (ABSI) in relation to PCa risk and mortality. We used data from 58,457 men from four Swedish cohorts to assess WC and ABSI in relation to PCa risk according to cancer risk category, including localised asymptomatic and symptomatic PCa and advanced PCa, and PCa-specific mortality. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During, on average, 10 years of follow-up, 3290 men were diagnosed with PCa and 387 died of PCa. WC was negatively associated with the risk of total PCa (HR per 10 cm, 0.95; 95% CI 0.92-0.99), localised PCa (HR per 10 cm, 0.93, 95% CI 0.88-0.96) and localised asymptomatic PCa cases detected through a prostate-specific antigen (PSA) test (HR per 10 cm, 0.87, 95% CI 0.81-0.94). WC was not associated with the risk of advanced PCa (HR per 10 cm, 1.02, 95% CI 0.93-1.14) or with PCa-specific mortality (HR per 10 cm, 1.04, 95% CI 0.92-1.19). ABSI showed no associations with the risk of PCa or PCa-specific mortality. While the negative association between WC and the risk of localised PCa was partially driven by PSA-detected PCa cases, no association was found between abdominal adiposity and clinically manifest PCa in our population.