Body mass index and prostate cancer incidence: a comprehensive systematic review

Prostate cancer, the second leading cause of cancer-related mortality among men in the U.S., is projected to cause over 36,000 deaths in 2025. This systematic literature review investigates the association between body mass index (BMI) and prostate cancer incidence, evaluating evidence from 2004 to October 2025.

A comprehensive search of PubMed using the keywords "BMI" and "prostate cancer" and "screening" identified 60 articles, from which 24 relevant studies were selected for direct analysis.

While some studies show a positive correlation between higher BMI and increased risk of prostate cancer, others report no significant association or an inverse relationship. Thus, the overall evidence supports a neutral relationship between BMI and prostate cancer risk.

The review explores potential biological mechanisms linking BMI to prostate cancer, including metabolic dysregulation, hormonal changes, and genetic factors. Additionally, it examines how factors such as age, race/ethnicity, and socioeconomic status may modify this relationship. The review highlights that although a higher BMI is generally associated with increased prostate cancer risk and poorer outcomes, the evidence is inconsistent. Key limitations include high variability in study designs and outcome measures, short follow-up periods as well as studies predominantly from Western populations. These inconsistencies underscore the need for further research to clarify the relationship and improve targeted interventions to mitigate prostate cancer's impact.