High bone density is associated with prostate cancer in older Afro-Caribbean men: Tobago Prostate Survey
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To test the hypothesis that bone mineral density (BMD), a possible surrogate of lifetime exposure to hormone/growth factor/vitamin D/calcium exposure, is higher in prostate cancer cases than controls.
Hip BMD was measured by dual X-ray absorptiometry in 222 Afro-Caribbean screening-detected prostate cancer cases and 1,503 screened non-cases, aged 45–79, in the population-based Tobago Prostate Survey. Because possible skeletal metastases may modulate BMD, men with prostate specific antigen >20 ng/ml or highly undifferentiated tumors (Gleason score ≥8) were excluded. Mean BMD, adjusted for age and body mass index, was compared in cases and non-cases by analysis of variance. Risk across age group-specific BMD quartiles was compared using logistic regression.
Overall, adjusted mean hip BMD was higher in cases (1.157 g/cm2) than non-cases (1.134 g/cm2) (p = 0.02). In men aged 60–79, prostate cancer risk was two-fold higher (OR, 2.12; 95% CI: 1.21–3.71) in the highest BMD quartile compared to the lowest. There was no association in younger men (interaction, p = 0.055).
High bone density is associated with prostate cancer among older men, consistent with an etiological role for lifetime exposure to factors which modulate bone density. However, other etiologies may dominate prostate cancer risk among younger men.
KeywordsAfro-Caribbean Bone mineral density Hormones Prostate cancer
Bone mineral density
Body mass index
Insulin-like growth factor I
Prostate specific antigen
Analysis of variance
National Health and Nutrition Examination Survey
- 1.Ries LAG, Eisner MP, Kosary CL, et al (eds) (2005) SEER Cancer Statistics Review, 1975–2002, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2002/, based on November 2004 SEER data submission, posted to the SEER web site 2005, Table XXII-2Google Scholar
- 2.Glover Jr FE, Coffey DS, Douglas LL, et al (1998) The epidemiology of prostate cancer in Jamaica. J Urol 159:1984–1987Google Scholar
- 3.Bunker, CH, Patrick, AL, Konety, BR, et al. 2002High prevalence of Screening-detected prostate cancer among Afro-Caribbeans: the Tobago Prostate SurveyCancer Epidemiol Biomark Prev11726729Google Scholar
- 5.Wu, AH, Whittemore, AS, Kolonel, LN, et al. 1995Serum androgens and sex hormone-binding globulins in relation to lifestyle factors in older African-American, white, and Asian men in the United States and CanadaCancer Epidemiol Biomark Prev4735741Google Scholar
- 20.Zmuda JM, Cauley JA, Ljung BM, Bauer DC, Cummings SR, Kuller LH. Study of Osteoporotic Fractures Research Group (2001) Bone mass and breast cancer risk in older women: differences by stage at diagnosis. J Nat Cancer Inst 93:930–936Google Scholar
- 21.Conover, CA 2000Insulin-like growth factors and the skeletonCanalis, E eds. Skeletal growth factorsLippincott Williams & WilkinsPhiladelphia USA101116Google Scholar
- 22.Wiren, KM, Orwoll, ES 1999Androgens and bone: basic aspectsOrwoll, ES eds. Osteoporosis in men: the effects of gender on skeletal healthAcademic PressSan Diego, USA211245Google Scholar
- 28.Cauley, J, Zmuda, JM, Patrick, A, Wheeler, VW, Hill, D, Bunker, C 2001Tobago Bone Health Study: Epidemiologic Study of high bone mineral density on a population levelJ Bone Min Res16M357Google Scholar
- 29.Nelson RL, Turyk M, Kim J, Persky V (2002) Bone mineral density and the subsequent risk of cancer in the NHANES I follow-up cohort. BMC Cancer 2:22 (accessed 12 March 2004 at http://www.biomedcentral.com/1471-2407/2/22)Google Scholar
- 37.Cauley, JA, Zmuda, JM, Newman, AB, et al. 2003Circulating levels of soluble cytokine receptors predict incident fractures in older men and women: The Health Aging and Body Composition Study (HABC)J Bone Miner Res18S84Google Scholar