Relationship Between Body Mass Index and Prostate Cancer Screening in the United States
ABSTRACT Obesity is associated with more advanced disease and worse outcomes in men with prostate cancer. To our knowledge the relationship between obesity and prostate cancer screening behavior in men 40 or older is unknown. Thus, we examined associations between body mass index and prostate cancer screening behavior.
We used the 2002 Behavioral Risk Factor Surveillance System to study prostate cancer screening in a representative sample of 57,827 men 40 years or older. Primary outcomes were the proportion of men ever screened and the proportion screened in the last year for prostate cancer.
Obese men were more likely than normal weight men to have had a prostate specific antigen test (62.1% vs 56.1%, p <0.001) and to have had a prostate specific antigen test in the last year (44.2% vs 38.2%, p <0.001). After controlling for sociodemographic characteristics obese men remained more likely than normal weight men to have had a prostate specific antigen test (OR 1.46, 95% CI 1.33-1.61) and to have had a prostate specific antigen test in the last year (OR 1.42, 95% CI 1.30-1.55). Respondents reporting an ongoing relationship with a physician (OR 2.88, 95% CI 2.57-3.22) and black nonHispanic men vs white men (OR 1.58, 95% CI 1.38-1.81) were also more likely to have had a prostate specific antigen test in the last year.
Obese men are more likely than normal weight men to be screened for prostate cancer. Associations between advanced stage, worse outcomes and obesity may not be explained by disparities in the screening of obese men for prostate cancer.
- SourceAvailable from: Heather Bittner Fagan
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- "Four studies examined the association between obesity and prostate cancer screening, and all used prostate-specific antigen (PSA) testing as their outcome. Three of the four studies indicated that obese men were more likely to have had a PSA test    when compared with their normal-weight peers. One study examined obesity and PSA testing in a cohort of men from primary care practices and found a consistent association with obesity and increased PSA testing, regardless of race  "
ABSTRACT: The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA) testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC) screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.Journal of obesity 12/2011; 2011:218250. DOI:10.1155/2011/218250
Article: Editorial commentUrology 08/2000; 56(1):106-7. DOI:10.1016/j.juro.2008.04.117 · 2.13 Impact Factor
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ABSTRACT: Both obesity and prostate cancer (PCa) are epidemic in Western society. Although initial epidemiological data appeared conflicting, recent studies have clarified the association between obesity and PCa. Therefore, we sought to review the epidemiological data linking obesity and PCa with an emphasis on the clinical implications and how to improve outcomes among obese men. A PubMed search using the keywords "prostate cancer" and "obesity" was performed. Relevant articles and references were reviewed for data on the association between obesity and PCa. Recent data suggest obesity is associated with reduced risk of nonaggressive disease but increased risk of aggressive disease. This observation may be explained in part by an inherent bias in our ability to detect PCa in obese men (lower PSA values and larger sized prostates, making biopsy less accurate for finding an existent cancer), which ultimately leads to increased risk of cancer recurrence after primary therapy and increased PCa mortality. Despite this detection bias potentially contributing to more aggressive cancers, multiple biological links also exist between obesity and PCa including higher estradiol, insulin, free IGF-1, and leptin levels, and lower free testosterone and adiponectin levels, all of which may promote more aggressive cancers. The association between obesity and PCa is complex. Emerging data suggest obesity increases the risk of aggressive cancer, while simultaneously decreasing the risk of more indolent disease. This is likely driven by both "biological" and "nonbiological" causes. Simple changes in clinical practice patterns can reduce the impact of nonbiological causes and may help improve PCa outcomes among obese men.European Urology 09/2007; 52(2):331-43. DOI:10.1016/j.eururo.2007.04.069 · 12.48 Impact Factor