Family history of prostate cancer and obesity in relation to high-grade disease and extraprostatic extension in young men with prostate cancer

BACKGROUND. Little is known about predictors of prostate cancer severity in young men. Therefore, we examined whether family history and obesity influence risk of high-grade disease and extraprostatic extension in men < 55-years old. METHODS. Four hundred ninety-eight men aged < 55 years who had had a radical prostatectomy (1992-1999) by one surgeon were mailed a survey in 2000 to assess family history of PCa and anthropometrics. Body mass index (BMI kg/m(2)) was calculated as an indicator of obesity. Logistic regression was used to compute odds ratios (OR) for high-grade disease (Gleason score greater than or equal to 7) and extraprostatic extension. RESULTS. Of the 363 respondents, 35.8% had at least one first-degree relative with PCa. Men with a family history were younger at surgery than those without a family history (48.8 vs. 50.1 years, P < 0.001). After controlling for age, cigarette smoking, and race/ethnicity, men with an affected father had a lower risk of high-grade disease compared to those without an affected father (OR = 0.42,95% Cl 0.23-0.76). Risk of high-grade disease increased with increasing BMI, especially in men < 50-years old (P-trend = 0.02). Family history and BMI were not clearly associated with extraprostatic extension. CONCLUSIONS. After taking into account a younger age at presentation among men with a family history, young men with a family history of PCa were less likely to have high-grade disease. Obesity may be associated with a poorer histology in young men with PCa, especially in men younger than 50 years of age. (C) 2003 Wiley-Liss, Inc.