Obese men more apt to have PSA test

NEW YORK (Reuters Health) - Men who are obese are more likely than normal weight men to undergo prostate-specific antigen (PSA) screening for prostate cancer, according to a new study.

"Obesity is associated with more advanced disease and worse outcomes in men with prostate cancer," note Dr. Judd W. Moul and colleagues from Duke University Medical Center, Durham, North Carolina in the Journal of Urology.

"To our knowledge, the relationship between obesity and prostate cancer screening behavior in men 40 or older is unknown."

The researchers analyzed data contained in a database on 57,827 men at least 40 years old. Forty-eight percent of the men were overweight and 25 percent were obese.

Nearly 60 percent of the men reported ever having a PSA blood test and 42 percent reported having a PSA test in the last year. PSA is a marker for prostate cancer, with higher PSA levels indicating an increased risk of the disease.

Overall, 62 percent of obese men ever had a PSA test, compared with 56 percent of normal weight men. Obese men were also more likely to have had a PSA test in the past year compared to normal weight men (44 percent versus 38 percent).

Men who had an ongoing relationship with a doctor and black non-Hispanic men were also more likely to have had a PSA test in the last year.

Moul and colleagues say, "higher screening rates in obese men suggest that disparities in prostate cancer outcomes in obese men do not arise from differences in screening behavior but they may be related to differences in tumor biology, performance characteristics of the PSA test in obese men or differential prostate biopsy rates after an elevated PSA test."

"Further investigation is required to confirm our findings and explain differences in prostate cancer outcomes in obese men," they conclude.

SOURCE: The Journal of Urology, February 2007.