To test multiple adiposity measures and prostate cancer (PC) risk in men undergoing prostate biopsy. We hypothesized that BMI, body fat and waist circumference would be highly correlated and all would be associated with aggressive PC, but not overall risk.

A case (483) -control (496) study among men undergoing prostate biopsy from 2007-2016 was conducted at the Durham Veterans Affairs Medical Center. Anthropometric measurements and self-reported were taken. Percent body fat was measured. Associations between adiposity measures and PC risk and high-grade PC (Gleason ≥7) were examined using logistic regression.

BMI, percent body fat, and waist circumference were highly correlated (ρ ≥0.79) (p<0.001). On multivariable analysis, BMI (p=0.011) was associated with overall PC risk, but percent body fat (p=0.16) and waist circumference (p=0.19) were not. However, all adiposity measurements were associated with high-grade disease (p<0.001). We found a strong relationship between self-reported and measured weight (ρ=0.97) and height (ρ=0.92).

BMI, body fat and waist circumference were all highly correlated and associated with aggressive PC. This study supports the idea that higher adiposity is selectively associated with high-grade PC and reinforces the continued use of self-reported BMI as a measure of obesity in epidemiological studies of PC.