Navigation Links
PSA screening may be biased against obese men, leading to more aggressive cancers
Date:8/7/2008

DURHAM, N.C. -- Testing men for elevated levels of prostate-specific antigen (PSA) in the blood -- the gold standard screening test for prostate cancer -- may be biased against obese men, whose PSA levels tend to be deceptively low. And this bias may be creating more aggressive cancers in this population by delaying diagnosis, according to a new study led by investigators in the Duke Prostate Center and the Durham Veterans Affairs (VA) Medical Center.

"We know that obese men tend to have lower PSA values than their normal-weight counterparts, possibly caused by larger blood volumes which dilute the readings," said Stephen Freedland, M.D., a urologist at Duke and the Durham VA, and lead investigator on this study. "Now we know some of the real implications of this -- that these men are at a disadvantage in terms of prognosis compared to normal-weight men."

The researchers published their findings online in the journal BJU International. The study was funded by the United States Department of Veterans Affairs, the National Institutes of Health, the Georgia Cancer Coalition, the United States Department of Defense, the Prostate Cancer Research Program and the American Urological Association Foundation's Astellas Rising Star in Urology Award, given to Freedland.

"We used patient data to examine the association between body mass index, or BMI -- a measure of obesity -- and the amount of disease discovered after surgery to remove the prostate, " Freedland said. "We compared men who had their cancers detected by PSA screening to those who had an abnormal digital rectal exam, which may not confer the same bias against obese men."

The researchers looked at a total of nearly 3,400 men in the years since 2000, when PSA screening became the gold standard test for prostate cancer.

Obese patients whose cancer was diagnosed by PSA testing had more than twice the risk of cancer recurrence after surgery than their normal-weight counterparts, Freedland said. "In contrast, obese men with abnormal digital rectal exams had similar outcomes as normal-weight men," Freedland said.

Another Duke study published in the same issue of the journal provides further substantiation of the concern that obese men have poorer prognoses than normal-weight men. This study showed that obese men have a higher rate of positive surgical margins after surgery to remove the prostate, meaning that there was a higher chance cancer was left behind.

This suggests that prostate cancer surgery is technically more challenging in obese men, making complete tumor removal harder, according to Jayakrishnan Jayachandran, M.D., a urological oncology fellow at Duke and lead investigator on the second study.

"The aggressiveness of obese men's tumors, coupled with the fact that they may be more difficult to remove, is like a double whammy for being obese," Jayachandran said.

"The least we can do is find a way to level the playing field when it comes to diagnostic tools," Freedland said.

PSA screening has been the most common tool used to detect prostate cancer over the past eight to ten years; men are less commonly diagnosed based on digital rectal exam alone.

The researchers are hopeful that this data, coupled with the earlier data on which it builds, may be a catalyst to encourage alternative screening methods for obese men, or a lower threshold for worrisome PSA levels in obese men.

"Obesity is very common in the United States, so this potentially affects a lot of people," Freedland said. "We can't forget that when we use the term obese we are not just talking about very, very large men. A man who is 5 foot 9 and weighs 203 pounds would be considered obese."


'/>"/>

Contact: Debbe Geiger
Debbe.Geiger@duke.edu
919-660-9461
Duke University Medical Center
Source:Eurekalert

Related medicine news :

1. Perceived discrimination affects screening rates
2. US Preventive Services Task Force updates prostate cancer screening recommendations
3. New Guidelines Rule Out Prostate Screening for Men Over 75
4. Convenience of screening mammography facilities plays major role in patient retention
5. Higher HIV infection estimate shows need for routine screening, more funding for care
6. American Kidney Fund Launches Screening Program in New York City
7. 2 different breast cancer screening strategies are equally effective
8. 2 Breast Cancer Screening Strategies Prove Effective
9. The Quantum Group Announces Exclusive Screening of New PWeR(TM) System
10. Colon Cancer Screening Rates Remain Low
11. New Law Signed by Governor Rendell Expands Newborn Screening in Pennsylvania
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ... , "Film editors can give their videos a whole new perspective by using the ... CEO of Pixel Film Studios. , ProSlice Levels contains over 30 Different presets ...
(Date:6/25/2016)... ... 2016 , ... Experts from the American Institutes for Research ... June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR experts ... planning, healthcare costs and patient and family engagement. , AIR researchers will be ...
(Date:6/25/2016)... , ... June 25, 2016 , ... First Choice ... States, named Dr. Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm ... Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical ...
(Date:6/25/2016)... ... ... Conventional wisdom preaches the benefits of moderation, whether it’s a matter of indulgence ... high can result in disappointment, perhaps even self-loathing. However, those who set the bar ... from PsychTests.com reveals that behind the tendency to set low expectations is ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Marcy was in a crisis. Her son James, ... out at his family verbally and physically. , “When something upset him, he couldn’t control ... use it. He would throw rocks at my other children and say he was going ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Global MEMS Devices Medical Market Analysis 2016 - Forecast to ... The report contains up to date financial ... reliable analysis. Assessment of major trends with potential impact on ... dive analysis of market segmentation which comprises of sub markets, ...
(Date:6/23/2016)... , June 23, 2016 Bracket , a ... its next generation clinical outcomes platform, Bracket eCOA (SM) ... on June 26 – 30, 2016 in Philadelphia ... electronic Clinical Outcome Assessment product of its kind to fully ... Bracket eCOA 6.0 is a flexible platform for ...
(Date:6/23/2016)... Colombia , June 23, 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new ... affiliate in Latin America . ... ... ... ...
Breaking Medicine Technology: