Association Between Smoking Status, and Free, Total and Percent Free Prostate Specific Antigen

Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
The Journal of urology (Impact Factor: 4.47). 02/2012; 187(4):1228-33. DOI: 10.1016/j.juro.2011.11.086
Source: PubMed


There are scant data available on the relationship between smoking and total prostate specific antigen, free prostate specific antigen and percent-free prostate specific antigen. Given the high prevalence of smoking and the frequency of prostate specific antigen screening, it is important to determine any association between smoking and prostate specific antigen values using nationally representative data.
Included in the final study population were 3,820 men 40 years old or older who participated in the 2001-2006 NHANES (National Health and Nutrition Examination Survey) and met the eligibility criteria for prostate specific antigen testing. The distributions of total, free and percent free prostate specific antigen were estimated by sociodemographic and clinical characteristics. Multivariate linear regression models were fit to determine the adjusted relationship between smoking and total and percent free prostate specific antigen while simultaneously controlling for these characteristics.
For all ages combined the median total and free prostate specific antigen levels were 0.90 (0.81-0.90) and 0.26 (0.25-0.28) ng/ml, respectively. Multivariate linear regression analysis showed that total prostate specific antigen was 7.9% and 12.2% lower among current and former smokers, respectively, than among never smokers. High body mass index and diabetes were also statistically significantly associated with a lower total prostate specific antigen. Approximately a third of the men had a percent free prostate specific antigen less than 25%. Current smokers had a significantly lower percent free prostate specific antigen than former smokers.
Our finding that smoking is inversely associated with total prostate specific antigen may have potential implications for the interpretation of prostate specific antigen levels in men who are current or former smokers. Given the high prevalence of smoking, obesity and diabetes, additional research on the combined effect of these health risk factors is warranted.

Download full-text


Available from: Viraj A Master, Jul 15, 2015
7 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background/Aim: Chronic obstractive pulmonary disease (COPD) in men has been associated with testosterone deficiency, known as the late-onset hypogonadism. Prostate cancer becomes more prevalent when testosterone values decline in males. We sought to determine endocrinological derangements that may affect PSA values in male patients with COPD. A total of 69 male patients with COPD and 82 healthy volunteers were divided into subgroups according to: their age: (i) ≤60 years and (ii) >60 years; or disease severity: (i) FEV1<50% and (ii) FEV1≥50% predicted. There was a significant reduction in total and free testosterone in patients with COPD. Patients with COPD aged >60 years had significantly lower free PSA compared to the control group. Alterations of the male hormonal status in COPD are related with older age (>60 years) and poorer lung function (FEV1<50% predicted). This may have implications for the use of the PSA-based screening tests in the elderly male population with COPD.
    In vivo (Athens, Greece) 09/2013; 27(5):641-9. · 0.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigate the effects of cigarette smoking on prostate-specific antigen (PSA) using 2 different age groups. The study was carried out between January 2007 and October 2011 with men; the 2 sets of age groups were: 25 to 35 years and 50 to 70 years old. The participants were divided into 4 groups. Of the 25 to 35 age range, smokers were Group 1, and non-smokers were Group 2; of the 50 to 70 age range, smokers were Group 3 and non-smokers Group 4. In addition, for the 50 to 70 age group, the International Prostate Symptom Score was completed, digital rectal examination was performed, and transabdominal prostate volume was measured. We wanted to see whether prostate-specific antigen (PSA) levels showed a difference between the 2 age groups. There were 114 patients in Group 1, 82 in Group 2, 90 in Group 3, and 102 in Group 4. The mean PSA level was 0.7 ± 0.28 ng/mL for Group 1, and 0.6 ± 0.27 ng/mL for Group 2 (p = 0.27), and there was no statistically significant difference between the 2 groups. The mean PSA was 2.5 ± 1.8 ng/mL for Group 3, and 2.1 ± 2.0 ng/mL (p = 0.59) for Group 4, and there was no statistically significant difference between the these 2 age groups. Cigarette smoking effects various hormone levels. Different from previous studies, the PSA level was higher in smokers compared to nonsmokers, although it was not statistically significant. Our study is limited by the small numbers in our study groups and the lack of PSA velocity data.
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 11/2013; 7(11-12):E704-E707. DOI:10.5489/cuaj.358 · 1.92 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study measures serum prostate-specific antigen (PSA) levels in tire-manufacturing workers, and attempts to find occupational or non-occupational factors that related to their PSA levels. A total of 1,958 healthy male workers (1,699 were production workers and 259 were office workers) took PSA measurement for analysis. After adjusting for age, body mass index, hypertension, regular exercise, alcohol drinking and smoking, which were significantly related to serum PSA levels or known related factors of serum PSA levels, the geometric mean PSA levels were significantly high in the office workers (p = 0.017), the older age group (p < 0.001), the group with hypertension (p = 0.046) and the group of individuals that do not exercise regularly (p = 0.015) and the office workers were more likely to have a serum PSA level of ≥4.0 (OR 7.73, 95% CI: 2.78-21.46) or 2.5 ng/mL (OR 2.74, 95% CI: 1.49-5.08). After stratifying by age and adjusting aforementioned covariates, office workers 50 years of age and older had the significantly higher geometric mean PSA levels (p = 0.017) and were more likely to have a serum PSA level of ≥4.0 ng/mL (OR 12.90, 95% CI: 3.65-45.64) or 2.5 ng/mL (OR 3.90, 95% CI: 1.64-9.25) than production workers 50 years of age and older. This study showed that serum PSA levels were significantly higher among the group with hypertension or the group of individuals that did not exercise regularly or group of office workers who were considered to have lesser physical activities.
    12/2014; 26(1):50. DOI:10.1186/s40557-014-0050-z
Show more