Online Program

Effect of lifestyle factors on PSA and PSA velocity

Tuesday, November 5, 2013

Amit Algotar, Ph.D., M.P.H., M.B.B.S., Cancer Center, University of Arizona, Tucson, AZ
Mitchell Sokoloff, MD, University of Arizona, Tucson
C Hsu, PhD, University of Arizona, Tucson, AZ
Parminder Singh, MD, University of Arizona, Tucson, AZ
Steven Stratton, PhD, University of Arizona, Tucson, AZ
Background: Smoking and obesity have been implicated in various carcinogenic processes. However, their role in prostate cancer (PCa) & their association with important biomarkers such as prostate specific antigen (PSA) & PSA velocity (rate of PSA) remains unresolved. This study investigates their association with PSA & PSA velocity (PSAV). Methods: Data were obtained from 699 men participating in a Phase 3 clinical trial aimed at investigating the effect of selenium supplementation on incidence of PCa. During the course of this trial 73 men were diagnosed with PCa. Results: As compared to non-smokers, smokers demonstrated statistically significant negative association with PSA (8.0 & 6.7ng/ml, p=0.02). This association was more pronounced in men diagnosed with PCa (14.7 & 9.9ng/ml) as compared to those not diagnosed with PCa (4.5 & 3.6ng/ml). As compared to non-obese subjects, obese subjects did not demonstrate a statistically significant association with PSA nor do these results change after stratifying the analysis by PCa status. Smoking was associated with statistically significant lower PSAV (p=0.008) whereas obesity was not. Using the standard PSA level of 4ng/ml as a cut off for conducting prostate biopsy, 14.6% of smokers in this study would not have been prescribed a prostate biopsy and thus misclassified as being negative for PCa. Conclusions: The negative association of smoking with PSA and PSA velocity could potentially be due to its negative effect on testosterone. Hence, increased vigilance may be warranted among smokers with borderline PSA to prevent the risk of delayed diagnosis and metastasis thus reducing morbidity and mortality associated with PCa.

Learning Areas:

Clinical medicine applied in public health

Learning Objectives:
Explain the relationship between lifestyle factors (smoking and obesity) and important biomarkers of prostate cancer

Keyword(s): Smoking, Cancer Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience in epidemiology of prostate cancer, with a special emphasis on the role of lifestyle factors such as obesity, smoking and medication use. I currently serve as the principle investigator of a department of defense sponsored project that investigates the role of biomarkers in prostate cancer epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.