Obesity may affect PSA blood test results when screening for prostate cancer

Freemasons Foundation Centre for Men’s Health (FFCMH) member Dr Arel Aref (PhD candidate and medical oncologist, Prostate Cancer Research Group, SAHMRI) with colleagues from the Centre, the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC), the Uni of Sydney, and Prof Peter Sutherland (senior Urologist) has published his first paper from his PhD research showing that the results of the most widely used test for prostate cancer may be affected by obesity.

In his research published in Endocrine Related Cancer, Adel examined data from 970 South Australian men from the Florey Adelaide Male Ageing Study, to determine the effects of obesity on prostate specific antigen (PSA) levels detected in blood and the influence of the sex steroid hormones, testosterone and estrogen.

Increases in PSA is an indication of inflammation, and consistently elevated levels of PSA in the blood can be an indicator of prostate cancer and lead to further diagnostic investigations.  PSA is also increased by the male sex steroid hormone, testosterone.

Adel and colleagues have shown that the concentration of PSA in the blood is lower in men who are obese (body mass index or BMI of 30 or higher) than in lean men, and that this can be attributed to lower concentrations of circulating testosterone.  The results of this study have implications for how we should interpret PSA levels in men who are obese and this is important given that 65% of men in Australia over the age of 25 are overweight or obese and this level is predicted to increase.  Further studies are now required to investigate effective strategies for applying this knowledge in clinical practice.

Adel’s supervisors from the FFCMH are Ass Professor Lisa Butler, Professor Gary Wittert and Dr Michael O’Callaghan.

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