Originally published 6/25/2015
Most of the studies on prostate cancer (PCa) risk factors, as well as the likelihood of aggressive disease, have focused on adult men. A standard list of primary risk factors includes family history of prostate and/or breast cancer, ethnicity, and exposure to environmental toxins. More recently, there is research into factors that occur earlier in life, including gestation, childhood and adolescence.
By way of updating this blog on childhood height and PCa probability, we cite a 2018 paper[i] by authors from three respected academic medical centers (Washington U, U of Michigan, and Harvard U). In studying the possible influence of childhood diet and body size into adulthood on developing PCa, the authors point to a chain of growth events that may ultimately set up the onset of prostate vulnerability to cancer.
The authors drew from existing data (the Longitudinal Studies of Child Health and Development) as well as previous animal and human studies. The also included birth length and childhood height to explore “the independent influence of genetics (i.e., birth length), and the combined influence of diet and genetics (height)” in their correlations.” Existing research linked childhood diets high in fat and animal protein, and body mass index (BMI) with earlier onset of puberty and taller height at age 13 and into adulthood. In turn, early puberty and greater adult height appear correlated with PCa risk. The authors hypothesize several reasons for the dual action of the Western diet in childhood plus genetic growth potential (height) as contributors to PCa:
- Increased leptin secretion
- Increased insulin-like growth factor and insulin secretion
- Increased androgen and other steroid hormone levels.
The earlier initiation of puberty as a result of these processes “has been proposed to contribute to later PCa risk largely by extending the time during which the prostate is exposed to androgens… In addition to promoting height, elevated levels of this growth factor may influence cancer risk by stimulating epithelial cell proliferation, preventing apoptosis [cell death], and amplifying the effects of DNA-damaging agents.”
Thus, this 2018 study supports the observed association between height at age 13 and subsequent PCa, and amplifies the biology behind diet, puberty onset, tallness and PCa risk
Jacques Cousteau, the French explorer of the oceanic realm, defined a scientist as “… a curious man looking through a keyhole, the keyhole of nature, trying to know what’s going on.” Nature has many mysteries. One of them concerns a possible connection between a man’s height and his risk of dying from prostate cancer (PCa). If you’ve ever wondered about it, you’re in good company at that keyhole.
Within the last 50 years, the American Cancer Society conducted two large Cancer Prevention Study cohorts. Both of them produced correlations between postmenopausal breast cancer and height. This led to curiosity about the relationship, if any, between PCa mortality and height. In 2001, Rodriguez et al.[ii] published an analysis of data from those two cohorts. They found that in Cohort I, the shortest men had the lowest rates of death from PCa, while men 73” and taller had the highest rates; for men 65-72” tall, rates were constant. However, in Cohort II, no association between height and mortality risk was found.
This year, a new Danish study was conducted along a slightly different line, based on population data that larger body mass and height are associated with “aggressive and fatal prostate cancers.”[iii] The authors wondered if the association begins much earlier than adulthood. They had access to the Copenhagen School Health Records Register with its hundreds of thousands of children’s health files recorded during their formative school years. They chose a study population of 125,208 men who were born between 1930-69 and whose height and weight were measured at ages from 7-13 years. They cross-referenced these men with data from the Danish Cancer Registry and the Register of Causes of Death. They identified men who were diagnosed with PCa, and those who eventually died specifically from it (not from other causes such as heart attack or stroke while they had PCa.
From that large pool, they found 630 men for whom PCa was named as the cause of death. Focusing on their height records from age 13, they found that tallness was “positively associated with prostate cancer-specific mortality.” While this was also significant at all other childhood ages, they reported that “… height at age 13 years had a stronger association with prostate cancer-specific mortality than height at age 7, suggesting the association at age 7 is largely mediated through later childhood height.” Survival rates were worse for the tallest 13-year olds who were younger than 60 when they were diagnosed.
In case you’re curious about the implications of this report, I have to say I don’t know. Does it imply that men who were taller than average when they were 13 should be more vigilant about being screened? The study does not shed any light on the matter, nor do the authors suggest that increased adolescent height is a risk factor for developing prostate cancer. They have simply confirmed previous observations that men who were taller than average by age 13 and who are diagnosed with prostate cancer may be at greater risk of having a more aggressive disease. So if you’re tall, if you sprouted early, and you’re curious, consider monitoring your PSA annually.
NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.
References
[i] Alimujiang A, Colditz GA, Gardner JD, Park Y et al. Childhood Diet And Growth In Boys In Relation To Timing Of Puberty And Adult Height: The Longitudinal Studies Of Child Health And Development. Cancer Causes Control. 2018 Oct; 29(10): 915–926.
[ii] http://cebp.aacrjournals.org/content/10/4/345.full.pdf+html
[iii] Aarestrup J, Gamborg M, Cook MB, Baker JL. Childhood height increases the risk of prostate cancer mortality. Eur J Cancer. 2015 Jul;51(10):1340-5. doi: 10.1016/j.ejca.2015.03.022. Epub 2015 Apr 17.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
