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Metabolic syndrome refers to a cluster of conditions that includes hypertension, dyslipidemia, central adiposity, and high blood glucose levels. Over the past decade, a growing body of literature suggests that metabolic syndrome may be associated with several different forms of cancer. Because prostate cancer risk is highest among African Americans, and these men, similarly, are more prone to developing specific features of the metabolic syndrome, including hypertension and type‐2 diabetes, any relationships would have a significant impact on developing strategies for the primary prevention of prostate cancer.The Flint Men''s Health Study is a community‐based, case‐control study of prostate cancer conducted exclusively among African Americans. Prostate cancer cases and controls completed an interviewer‐administered questionnaire that asked about the respondent''s history of high blood pressure and diabetes. All men also participated in a physical examination in which several measures of body composition, including waist circumference, were collected.Hypertension was reported more commonly among men with prostate cancer (cases) compared with men in the control group (odds ratio [OR]. 2.4; 95% confidence interval [95% CI], 1.5–3.7), and cases were more likely to have a waist circumference >102 cm (OR, 1.8; 95% CI, 1.2–2.9). However, self‐reported diabetes was not associated with prostate cancer risk. The men with prostate cancer also were more likely than controls to exhibit multiple syndrome characteristics (OR, 1.9; 95% CI, 1.2–3.0).The current results indicated that features of the metabolic syndrome, specifically abdominal obesity and hypertension, are associated with prostate cancer in African‐American men. This relationship, if it is proved causal, suggests that prevention or control of these conditions eventually may lead to a reduction in the incidence of prostate cancer in this high‐risk minority group. Cancer 2007 © 2007 American Cancer Society. [ABSTRACT FROM AUTHOR]