PSA Testing May Miss Cancer in Obese Men
Posted on: Saturday, 26 February 2005, 03:00 CST
GPs could be missing early signs of prostate cancer in overweight men, according to a US study.
The diagnosis of prostate cancer could be delayed because obesity may be associated with lower levels of prostate specific antigen (PSA).
The researchers compared the BMI and PSA levels of 2,770 men without prostate cancer.
Men with a normal BMI had an average PSA value of l.Olng/ml, but as BMI increased, PS A levels fell. In overweight men the average was 0.95ng/ml, and in the morbidly obese it was 0.69ng/ml.
Lead author Dr Jacques Baillargeon of the Centre for Epidemiology and Biostatistics at the University of Texas Health Sciences Centre said that the lower PSA levels observed in overweight and obese men may have meant that rises in their levels were not noticed, thus delaying diagnosis.
'This delay, in turn, may be linked to the more aggressive disease and poorer overall survival outcomes that have been reported in obese men,' he said. 'It may be appropriate to look at low PSA values in obese men more closely.'
But, Dr Geoffrey Hackett, a GP and consultant in andrology at Good Hope Hospital, Sutton Coldfield, said that it was Overkill' to suggest that lower PSA levels could mask disease.
He said that PSA cut-off points were not interpreted rigidly enough for the decreased values to have a significant clinical impact.
PSA testing in the UK has increased in recent years.Two per cent of asymptomatic men in England and Wales are tested.
Cancer 2005; 24 January online www.interscience.wiley.com
rachel.bowden@haynet.com
Copyright Haymarket Business Publications Ltd. Feb 4, 2005
Source: GP
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