THE "NEW" PROSTATE CANCER INFOLINK

The “New” Prostate Cancer InfoLink has been pointing out (on a fairly regular basis over the past 5 years) that at least some of our risk for prostate cancer (other than the genetic risks) may be affected by what happens to us in childhood.

One of the key things that happens to us in childhood is that we grow. And over the past 150 or so years there has been a clear increase in the average height of the average male (and the average female too) in many countries around the world. What is more, we know that greater adult male height has been positively associated with greater risk for prostate cancer.

A new study by Cook et al., from the Danish National Cancer Institute, has taken advantage of the data in the Copenhagen School Health Records Register (CSHRR) to see if the authors were able to associate risk for prostate cancer with the heights and weights of male children born between 1930 and 1969. During this time period, the CSHRR was collecting such data annually for > 370,000 school-aged children between 7 and 13 years of age, and because of the way that medical data are collected and collated in Denmark, it was also possible to correlate these data to a later diagnosis of prostate cancer.

(It should, of course, be noted that the children attending schools in Copenhagen in the period from 1930 to 1969 had a very high probability of Caucasian ethnicity. The proportion of non-Caucasian children in this group would have been very low.)

So here is what Cook et al. have reported:

• Data from 125,211 male children in the CSHRR were available and suitable for analysis.
• 2,987/125,211 children (2.4 percent) were subsequently diagnosed with prostate cancer as adults during 2.57 million person-years of follow-up.
• Height z-score (a specific type of “average” height) was significantly associated with prostate cancer risk at all ages (hazard ratio [HR] = ~1.13).
• Height at age 13 years was more important than height change (p = 0.024) and height at age 7 years (p = 0.024) in prediction of risk for prostate cancer.
• Adjustment for birth weight did not alter estimates ascertained.
• Birth weight was not associated with prostate cancer risk.

The authors conclude that, given the association between childhood height at age 13 years and prostate cancer risk was driven by height at age 13 years, things that affect growth during late childhood, adolescence and adulthood may be significant to long-term risk for prostate cancer (although what happens in this time period is unlikely to be the only key factor “given the complexity of both human growth and carcinogenesis”).

What is really interesting here is the question of whether diet in childhood today (by comparison with 100 years or so ago) is (a) providing better nutrition that has lead to a major increase in average heights of children and adults; (b) been a key factor in extending life (which has also occurred over the past 100 years); and (c) done this in a way that increases risk for prostate cancer among taller men as opposed to shorter ones. The other strong possibility is that the genetic factors underlying “tallness” may simply be associated with the genetic factors than increase risk for prostate cancer.

Which came first, the chicken or the egg?

Filed under: Diagnosis, Risk | Tagged: age, childhood, diet, Height, risk, weight |