Body Mass Index as a Risk Factor for Prostate Cancer and Benign Prostate Hypertrophy: a Comparative Study at Three Reference Hospitals in Cameroon

Sando Zacharie, Lemonge Norbert Nkapleweh, Mbassi Achille, Mekeme Junior Barthelemy, Fouogue Tsuala Jovanny, Fouelifack Ymele, Angwa Fo III F Fru

Abstract


Introduction: Prostate cancer (PCa) is the second most commonly diagnosed cancer and the sixth most common cause of cancer-related mortality among men worldwide. Obesity increases the prevalence and mortality of multiple cancers. Consequently, the relationship between obesity and cancer is receiving more and more attention.

Objective: To evaluate the impact of body mass index (BMI) on prostate cancer detection and aggressiveness in Cameroonian population.

Methodology: This was a comparative cross-sectional study carried out at the hospitals in Cameroon. The study included Cameroonians who underwent prostate biopsies during a 9-year period, from 2008 to 2016. We analysed the BMI, age, prostate volume, and PSA of patients with prostate cancer in comparison with patients with benign prostate tissue who underwent prostate biopsies. Data entry was performed using CSpro 6.3.2, analysis was done using SPSS version 23.0.

Results: A total of 316 patients were included in our study, 158 PCa and 158 BPH. The patients had a mean age ± standard deviation of 67.8 ± 10.32 with a modal class of 61 and 70 years. In our study, the mean age ± SD of the PCa group (71.48 ± 8.96) was significantly greater than that of the BPH group (64.17 ± 10.31) (p<0.001).The PCa group had a mean BMI ± SD of 24.80 ± 4.07 while in the BPH group it was 24.49 ± 3.68, p = 0.472. Amongst the patients with high BMI, 71(52.2%) had prostate cancer while 65 (47.8%) had benign tissue. Amongst the patients with low BMI, 87(48.3%) had prostate cancer while 93 (51.4%) had benign tissue. The odds ratio was 1.168 with a 95% confidence interval of 0.748 to 1.823 (p>0.05). The median total PSA and the median PSA f/t ratio was significantly different in both groups (p<0.001 and p = 0.006). A Gleason score of 7 was the most frequent. Amongst those with a high BMI 77.5% (55) had a high Gleason score, which was significantly higher than the fraction in the low BMI group (60.9%) (53) (P = 0.026).

Conclusion: We therefore conclude that BMI is not an independent risk factor for the development of prostate cancer; rather, it is associated with High Gleason PCa.


Keywords


BPH, BMI, Gleason Score, Prostate cancer

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