Body mass index affects the diagnosis and progression of prostate cancer in Hispanics.
BACKGROUND
The occurrence of lower prostate-specific antigen (PSA) levels in overweight White and African American men has been studied, but there is no data regarding Hispanics, which have a higher mortality rate from Prostate Cancer (PCa) than Whites. The objective of this study was to investigate if being overweight could affect both the sensitivity of the PSA as a diagnostic tool and the progression of PCa in this group.


METHODS
Retrospective study of records from 400 patients that underwent testing for PCa during 2005 and 400 patients under treatment for PCa from 2003-2005 at the urology clinics of the Veterans Administration Caribbean Healthcare System. Accrued data included body mass index (BMI), age, PSA levels, biopsy results, and cancer status after treatment.


RESULTS
In men, with normal age adjusted PSA levels, overweight and obese men had 35.38% and 38.13%, respectively, positive biopsies while men with normal BMI had 26.15%. In addition, 73.84% of overweight men over 61 years old with normal PSA were positive for prostate cancer. There is a statistically significant decrease in PSA sensitivity from 71.7 (95% CI: 58.6-82.5) in men with normal BMI to 55.4 (95% CI: 41.5-68.7) in obese men (P = .015). In multivariate analysis, patients with a BMI over 25 kg/m2 had a 2.63 (CI 95%: 1.23-5.64) fold higher risk of metastases than those with normal BMI.


CONCLUSIONS
in overweight Hispanic men the PSA level is a less sensitive marker for PCa and those individuals with higher BMI have higher prevalence of metastatic disease.
Graduate Department, Clinical Laboratory Sciences, School of Health Professions, Medical Sciences Campus, University of Puerto Rico.
Rosa
R
Negrón
Andrea
A
Vásquez
Mariely
M
Nieves
Lourdes
L
Guerrios
Margarita
M
Irizarry-Ramírez
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D018450:Disease Progression; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen