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BACKGROUND: There are inconsistent data regarding the association between metabolic factors, separately and combined, and the risk of prostate cancer and death from prostate cancer. METHODS: In the Metabolic Syndrome and Cancer Project (Me-Can), data on body mass index (BMI); blood pressure; and blood levels of glucose, cholesterol, and triglycerides were collected for 289,866 men. Cox proportional hazard models were used to calculate relative risks (RRs) by exposures in quintiles as well as for z scores (with a mean of 0 and a standard deviation of 1) together with a composite sum of scores to assess the combined effect of metabolic fac-tors. RRs were corrected for random errors in measurement. RESULTS: During a mean follow-up of 12 years, 6673 men were diag-nosed with prostate cancer and 961 died of the disease. Men with high levels of glucose and triglycerides were found to have a decreased risk of prostate cancer: top versus bottom quintile of glucose: RR, 0.82 (95 % confidence interval [95 % CI], 0.62-1.08; P value for trend .03) and top versus bottom quintile of triglycerides: RR, 0.88 (95 % CI, 0.74-1.04; P value for trend .001). High BMI