Investigating the prostate specific antigen, body mass index and age relationship: is an age-BMI-adjusted PSA model clinically useful?

Purpose: Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an a...

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Publicado en:Cancer Causes & Control Vol. 27; no. 12; pp. 1465 - 1475
Autores principales: Harrison, Sean, Tilling, Kate, Turner, Emma, Lane, J., Simpkin, Andrew, Davis, Michael, Donovan, Jenny, Hamdy, Freddie, Neal, David, Martin, Richard, Turner, Emma L, Lane, J Athene, Hamdy, Freddie C, Neal, David E, Martin, Richard M
Formato: research tables/charts Journal Article
Publicado: Springer Nature Dec2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2016
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10552-016-0827-1
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        atl: Investigating the prostate specific antigen, body mass index and age relationship: is an age-BMI-adjusted PSA model clinically useful?
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          Harrison, Sean
          Tilling, Kate
          Turner, Emma
          Lane, J.
          Simpkin, Andrew
          Davis, Michael
          Donovan, Jenny
          Hamdy, Freddie
          Neal, David
          Martin, Richard
          Turner, Emma L
          Lane, J Athene
          Hamdy, Freddie C
          Neal, David E
          Martin, Richard M
        affil: School of Social and Community Medicine , University of Bristol , Canynge Hall, 39 Whatley Road Bristol BS8 2PS UK
      sug:
        subj:
          Prostatic Neoplasms Epidemiology
          Prostate-Specific Antigen Analysis
          Blood Coagulation Factors Analysis
          Obesity Epidemiology
          Male
          Aged
          Age Factors
          Case Control Studies
          Clinical Trials
          Cross Sectional Studies
          Early Detection of Cancer
          Prostatic Neoplasms Diagnosis
          Middle Age
          Body Mass Index
          Human
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
      ab: Purpose: Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age-BMI-adjusted PSA model would be clinically useful for detecting prostate cancer.Methods: Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer. Of 18,238 men aged 50-69 years, 9,457 men without screen-detected prostate cancer (controls) and 1,836 men with prostate cancer (cases) met inclusion criteria: no history of prostate cancer or diabetes; PSA < 10 ng/ml; BMI between 15 and 50 kg/m2. Multivariable linear regression models were used to investigate the relationship between log-PSA, age, and BMI in all men, controlling for prostate cancer status.Results: In the 11,293 included men, the median PSA was 1.2 ng/ml (IQR: 0.7-2.6); mean age 61.7 years (SD 4.9); and mean BMI 26.8 kg/m2 (SD 3.7). There were a 5.1% decrease in PSA per 5 kg/m2 increase in BMI (95% CI 3.4-6.8) and a 13.6% increase in PSA per 5-year increase in age (95% CI 12.0-15.1). Interaction tests showed no evidence for different associations between age, BMI, and PSA in men above and below 3.0 ng/ml (all p for interaction >0.2). The age-BMI-adjusted PSA model performed as well as an age-adjusted model based on National Institute for Health and Care Excellence (NICE) guidelines at detecting prostate cancer.Conclusions: Age and BMI were associated with small changes in PSA. An age-BMI-adjusted PSA model is no more clinically useful for detecting prostate cancer than current NICE guidelines. Future studies looking at the effect of different variables on PSA, independent of their effect on prostate cancer, may improve the discrimination of PSA for prostate cancer.
      pubtype: Academic Journal
      doctype:
        research
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        Journal Article
      ougenre: Article
    language: English
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