Although patients with obesity have demonstrated lower incidences of prostate cancer, cancer progression and mortality are much higher in these cases. This study sought to understand the role of obesity in cases of prostate cancer, including why patients with obesity are diagnosed less often but with increased mortality rates.
The researchers used three nationally representative cross-sectional surveys to analyze these factors. Patient testosterone concentrations, prostate-specific antigen (PSA), and prostate cancer biopsy rates were collected. Averages were computed for testosterone levels, PSA concentrations, and biopsy rates for each BMI category.
Among the study participants, all BMI groups had similar rates of PSA testing. Concentrations of testosterone were inversely associated with the patients with a BMI that classified them as obese.
The averages revealed that men with obesity were less likely to have a PSA that reached the biopsy threshold (greater than 4 ml). Biopsy rates were also lower in men with BMI grade obesity (≥30) at 4.6% versus the 5.8% biopsy rate in men with a healthy BMI (≤25). From this data, it can be concluded that obesity is associated with lower prostate-specific antigen.
These data support a hypothesis that obesity may be a factor in lower rates of prostate cancer diagnosis and higher rates of prostate cancer mortality. Obesity may hinder early diagnosis and the ability to identify high-risk patients by decreasing PSA-driven biopsy rates. A call to action is made for further research studies on how to improve prostate cancer risk detection in patients with obesity .
Source: Parekh, N., Lin, Y., DiPaola, R. S., Marcella, S., & Lu-Yao, G. (2010). Obesity and Prostate Cancer Detection: Insights from Three National Surveys. The American Journal of Medicine, 123(9), 829–835. https://doi.org/10.1016/j.amjmed.2010.05.011