Advertisement
Review| Volume 71, ISSUE 4, P554-560, April 2008

Body Composition and Serum Prostate-Specific Antigen: Review and Findings from Flint Men’s Health Study

Published:February 27, 2008DOI:https://doi.org/10.1016/j.urology.2007.11.049
      Recent studies have suggested that obesity is associated with lower serum prostate-specific antigen levels, perhaps influencing the recommendation for prostate biopsy and potentially explaining part of the observed poorer prognosis among obese men. African-American men have the greatest rates of prostate cancer and are more likely to die of the disease, making early detection a priority in this group. We present findings from the Flint Men’s Health Study, a study of African-American men, that are consistent with most studies suggesting that overweight men have prostate-specific antigen levels that are 0.15 to 0.30 ng/mL lower than those who are not overweight. We have coupled our results with a systematic review of publications in this area.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Stamey T.A.
        • Yang N.
        • Hay A.R.
        • et al.
        Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate.
        N Engl J Med. 1987; 317: 909-916
        • Hernandez J.
        • Thompson I.M.
        Prostate-specific antigen: a review of the validation of the most commonly used cancer biomarker.
        Cancer. 2004; 101: 894-904
        • Thompson I.
        • Leach R.J.
        • Pollock B.H.
        • et al.
        Prostate cancer and prostate-specific antigen: the more we know, the less we understand.
        J Natl Cancer Inst. 2003; 95: 1027-1028
        • Thompson I.M.
        • Pauler D.K.
        • Goodman P.J.
        • et al.
        Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter.
        N Engl J Med. 2004; 350: 2239-2246
        • Ankerst D.P.
        • Thompson I.M.
        Sensitivity and specificity of prostate-specific antigen for prostate cancer detection with high rates of biopsy verification.
        Arch Ital Urol Androl. 2006; 78: 125-129
        • Stamey T.A.
        • Caldwell M.
        • McNeal J.E.
        • et al.
        The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years?.
        J Urol. 2004; 172: 1297-1301
        • Freedland S.J.
        • Terris M.K.
        • Presti Jr, J.C.
        • et al.
        Obesity and biochemical outcome following radical prostatectomy for organ confined disease with negative surgical margins.
        J Urol. 2004; 172: 520-524
        • Amling C.L.
        • Riffenburgh R.H.
        • Sun L.
        • et al.
        Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy.
        J Clin Oncol. 2004; 22: 439-445
        • Amling C.L.
        • Kane C.J.
        • Riffenburgh R.H.
        • et al.
        Relationship between obesity and race in predicting adverse pathologic variables in patients undergoing radical prostatectomy.
        Urology. 2001; 58: 723-728
        • Gong Z.
        • Neuhouser M.L.
        • Goodman P.J.
        • et al.
        Obesity, diabetes, and risk of prostate cancer: results from the prostate cancer prevention trial.
        Cancer Epidemiol Biomarkers Prev. 2006; 15: 1977-1983
        • Rodriguez C.
        • Freedland S.J.
        • Deka A.
        • et al.
        Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort.
        Cancer Epidemiol Biomarkers Prev. 2007; 16: 63-69
        • Strom S.S.
        • Wang X.
        • Pettaway C.A.
        • et al.
        Obesity, weight gain, and risk of biochemical failure among prostate cancer patients following prostatectomy.
        Clin Cancer Res. 2005; 11: 6889-6894
        • Wright M.E.
        • Chang S.C.
        • Schatzkin A.
        • et al.
        Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality.
        Cancer. 2007; 109: 675-684
        • Freedland S.J.
        • Platz E.A.
        Obesity and prostate cancer: making sense out of apparently conflicting data.
        Epidemiol Rev. 2007; 29: 88-97
        • Baillargeon J.
        • Pollock B.H.
        • Kristal A.R.
        • et al.
        The association of body mass index and prostate-specific antigen in a population-based study.
        Cancer. 2005; 103: 1092-1095
        • Cooney K.A.
        • Strawderman M.S.
        • Wojno K.J.
        • et al.
        Age-specific distribution of serum prostate-specific antigen in a community-based study of African-American men.
        Urology. 2001; 57: 91-96
        • Heeringa S.G.
        • Alcser K.H.
        • Doerr K.
        • et al.
        Potential selection bias in a community-based study of PSA levels in African-American men.
        J Clin Epidemiol. 2001; 54: 142-148
        • Lean M.E.
        • Han T.S.
        • Morrison C.E.
        Waist circumference as a measure for indicating need for weight management.
        BMJ. 1995; 311: 158-161
        • Ogden C.L.
        • Carroll M.D.
        • Curtin L.R.
        • et al.
        Prevalence of overweight and obesity in theUnited States, 1999–2004.
        JAMA. 2006; 295: 1549-1555
        • National Center for Health Statistics, 1999
        (Accessed June 20, 2007)
        • Colditz G.A.
        Economic costs of obesity and inactivity.
        Med Sci Sports Exerc. 1999; 31: S663-S667
        • Manson J.E.
        • Skerrett P.J.
        • Greenland P.
        • et al.
        The escalating pandemics of obesity and sedentary lifestyle: a call to action for clinicians.
        Arch Intern Med. 2004; 164: 249-258
        • Davi G.
        • Guagnano M.T.
        • Ciabattoni G.
        • et al.
        Platelet activation in obese women: role of inflammation and oxidant stress.
        JAMA. 2002; 288: 2008-2014
        • Harvie M.
        • Hooper L.
        • Howell A.H.
        Central obesity and breast cancer risk: a systematic review.
        Obes Rev. 2003; 4: 157-173
        • Kaaks R.
        • Lukanova A.
        • Kurzer M.S.
        Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review.
        Cancer Epidemiol Biomarkers Prev. 2002; 11: 1531-1543
        • Lukanova A.
        • Lundin E.
        • Zeleniuch-Jacquotte A.
        • et al.
        Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women.
        Eur J Endocrinol. 2004; 150: 161-171
        • Sandhu M.S.
        • Gibson J.M.
        • Heald A.H.
        • et al.
        Association between insulin-like growth factor-I: insulin-like growth factor-binding protein-1 ratio and metabolic and anthropometric factors in men and women.
        Cancer Epidemiol Biomarkers Prev. 2004; 13: 166-170
        • Schottenfeld D.
        • Beebe-Dimmer J.L.
        Advances in cancer epidemiology: understanding causal mechanisms and the evidence for implementing interventions.
        Ann Rev Pub Health. 2005; 26: 37-60
        • Amling C.L.
        • Riffenburgh R.H.
        • Sun L.
        • et al.
        Pathologic variables and recurrence rates as related to obesity and race in men with prostate cancer undergoing radical prostatectomy.
        J Clin Oncol. 2004; 22: 439-445
        • Freedland S.J.
        • Aronson W.J.
        • Kane C.J.
        • et al.
        Impact of obesity on biochemical control after radical prostatectomy for clinically localized prostate cancer: a report by the Shared Equal Access Regional Cancer Hospital database study group.
        J Clin Oncol. 2004; 22: 446-453
        • Rodriguez C.
        • Patel A.V.
        • Calle E.E.
        • et al.
        Body mass index, height, and prostate cancer mortality in two large cohorts of adult men in the United States.
        Cancer Epidemiol Biomarkers Prev. 2001; 10: 345-353
        • Calle E.E.
        • Rodriguez C.
        • Walker-Thurmond K.
        • et al.
        Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.
        N Engl J Med. 2003; 348: 1625-1638
        • Buschemeyer III, W.C.
        • Freedland S.J.
        Obesity and prostate cancer: epidemiology and clinical implications.
        Eur Urol. 2007; 52: 331-343
        • Thompson I.M.
        • Ankerst D.P.
        • Chi C.
        • et al.
        Assessing prostate cancer risk: results from the Prostate Cancer Prevention Trial.
        J Natl Cancer Inst. 2006; 98: 529-534
        • Schottenfeld D.
        • Colditz G.A.
        Prostate cancer screening practices and cancer control research (United States).
        Cancer Causes Control. 2002; 13: 1-5
        • Bosch J.L.
        • Hop W.C.
        • Bangma C.H.
        • et al.
        Prostate specific antigen in a community-based sample of men without prostate cancer: correlations with prostate volume, age, body mass index, and symptoms of prostatism.
        Prostate. 1995; 27: 241-249
        • Smith D.S.
        • Carvalhal G.F.
        • Mager D.E.
        • et al.
        Use of lower prostate specific antigen cutoffs for prostate cancer screening in black and white men.
        J Urol. 1998; 160: 1734-1738
        • Thompson I.M.
        • Leach R.
        • Troyer D.
        • et al.
        Relationship of body mass index and prostate specific antigen in a population-based study.
        Urol Oncol. 2004; 22: 127-131
        • Kristal A.R.
        • Chi C.
        • Tangen C.M.
        • et al.
        Associations of demographic and lifestyle characteristics with prostate-specific antigen (PSA) concentration and rate of PSA increase.
        Cancer. 2006; 106: 320-328
        • Fowke J.H.
        • Signorello L.B.
        • Chang S.S.
        • et al.
        Effects of obesity and height on prostate specific antigen (PSA) and percentage of free PSA levels among African-American and Caucasian men.
        Cancer. 2006; 107: 2361-2367
        • Barqawi A.B.
        • Golden B.K.
        • O’Donnell C.
        • et al.
        Observed effect of age and body mass index on total and complexed PSA: analysis from a national screening program.
        Urology. 2005; 65: 708-712
        • Werny D.M.
        • Thompson T.
        • Saraiya M.
        • et al.
        Obesity is negatively associated with prostate-specific antigen in U.S. men, 2001–2004.
        Cancer Epidemiol Biomarkers Prev. 2007; 16: 70-76
        • Ku J.H.
        • Kim M.E.
        • Lee N.K.
        • et al.
        Influence of age, anthropometry, and hepatic and renal function on serum prostate-specific antigen levels in healthy middle-age men.
        Urology. 2003; 61: 132-136
        • Ochiai A.
        • Fritsche H.A.
        • Babaian R.J.
        Influence of anthropometric measurements, age, and prostate volume on prostate-specific antigen levels in men with a low risk of prostate cancer.
        Urology. 2005; 66: 819-823
        • Fowke J.H.
        • Motley S.S.
        • Cookson M.S.
        • et al.
        The association between body size, prostate volume and prostate-specific antigen.
        Prostate Cancer Prostatic Dis. 2007; 10: 137-142