Epidemiologic evidence shows that obesity is associated with a greater risk of aggressive prostate cancer (PCa) and PCa-specific mortality and this is observed mainly in men with the <i>TMPRSS2-ERG</i> gene fusion.
Higher body mass index (BMI) at baseline (per 5 kg/m<sup>2</sup> HR 0.75; 95% CI, 0.61-0.91; <i>P</i><sub>heterogeneity</sub> = 0.02) and updated BMI over time (per 5 kg/m<sup>2</sup> HR 0.86; 95% CI, 0.74-1.00; <i>P</i><sub>heterogeneity</sub> = 0.07) were associated with a reduced risk of ERG-positive disease only.<b>Conclusions:</b> Our results indicate that anthropometrics may be uniquely associated with <i>TMPRSS2:ERG</i>-positive prostate cancer; taller height may be associated with greater risk, whereas obesity may be associated with lower risk.<b>Impact:</b> Our study provides strong rationale for further investigations of other prostate cancer risk factors that may be distinctly associated with subtypes.
Two studies found that the associations between obesity and prostate cancer (ie, fewer low-grade cancers and yet more aggressive cancers) was limited to men with TMPRSS2-ERG-positive tumors.