Exploring the Relationship Between Body Mass Index and Prostate Cancer Incidence: A Comprehensive Systematic Literature Review

Abstract

Prostate cancer is the second leading cause of male cancer-related mortality in the United States, with an estimated 299,010 new cases and 35,250 deaths expected in 2024. This systematic literature review aims to explore the relationship between body mass index (BMI) and prostate cancer incidence, focusing on existing evidence, potential modifiers, geographical disparities, and underlying biological mechanisms. The keywords used were “BMI” and “prostate cancer screening”. The inclusion criteria were studies involving prostate cancer patients and BMI metrics. Out of 22,705 articles initially identified with “BMI” (19,589) and “prostate cancer screening” (3116). 58 studies met the inclusion criteria, yet only 22 were used based on inclusion of specific BMI metrics. 17 additional articles were used to support the analysis. Studies before 2004 were excluded. Some studies indicated a positive correlation between higher BMI and increased risk of advanced prostate cancer, while others reported no significant association or even an inverse relationship. Potential biological mechanisms linking BMI to prostate cancer include metabolic dysregulation, hormonal influences, and genetic pathways. The relationship between BMI and prostate cancer incidence is influenced by age, race/ethnicity, and socioeconomic status. While higher BMI is generally associated with increased risks and poorer outcomes in prostate cancer patients, contradictory findings highlight the need for further research. Some limitations include high heterogeneity in study designs and outcome measures, potential publication bias, selective reporting of positive outcomes, and short follow-up periods limiting long-term outcome assessment. Overall, understanding the underlying mechanisms and modifiers is crucial for developing targeted interventions to reduce the burden of prostate cancer.