MP60-09 DOES OBESITY MODIFY THE ABILITY OF PRE-BIOPSY PSA TO DETECT PROSTATE CANCER ON REPEAT BIOPSY? RESULTS FROM THE REDUCE STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening II1 Apr 2015MP60-09 DOES OBESITY MODIFY THE ABILITY OF PRE-BIOPSY PSA TO DETECT PROSTATE CANCER ON REPEAT BIOPSY? RESULTS FROM THE REDUCE STUDY Adriana C. Vidal, Lauren E. Howard, Daniel M. Moreira, Ramiro Castro-Santamaria, Gerald L. Andriole, and Stephen J. Freedland Adriana C. VidalAdriana C. Vidal More articles by this author , Lauren E. HowardLauren E. Howard More articles by this author , Daniel M. MoreiraDaniel M. Moreira More articles by this author , Ramiro Castro-SantamariaRamiro Castro-Santamaria More articles by this author , Gerald L. AndrioleGerald L. Andriole More articles by this author , and Stephen J. FreedlandStephen J. Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2211AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Higher BMI is linked to lower PSA. This has given rise to concerns PSA may be less reliable for predicting prostate cancer among obese men. Thus, we examined the accuracy of pre-biopsy PSA for predicting prostate cancer across BMI categories. METHODS We used the REDUCE study, which tested dutasteride for prostate cancer risk reduction in men with a PSA of 2.5-10.0 ng/mL and a negative pre-study biopsy. All men were required to have a biopsy at 2- and 4-years independent of PSA. Using only data from the study-mandated 2-year biopsy, we assessed the performance of pre-biopsy PSA to predict overall and high-grade prostate cancer (Gleason sum ≥7) within each BMI category using the area under the ROC curve (AUC). RESULTS Of 6,103 men who had a 2-year biopsy, 1,646 (27%) were normal weight, 3,209 (53%) overweight, and 1,248 (20%) were obese. Mean-adjusted PSA values for normal weight, overweight, and obese subjects on placebo were 7.73, 7.17, and 6.79 ng/mL (p-trend=0.192), and on dutasteride were 3.16, 2.93, and 2.62 ng/mL (p=0.008). AUCs for predicting prostate cancer within the BMI categories ranged from 0.60-0.64 in the placebo arm and from 0.58-0.66 in the dutasteride arm with no difference across BMI categories (p>0.1). Similar results were found for high-grade prostate cancer with AUCs ranging from 0.69-0.70 in the placebo arm and 0.65-0.75 in the dutasteride arm but no differences across BMI categories (p>0.18). CONCLUSIONS Among men with a previous negative biopsy, the accuracy of pre-biopsy PSA to predict overall and high-grade prostate cancer was independent of BMI. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e741 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adriana C. Vidal More articles by this author Lauren E. Howard More articles by this author Daniel M. Moreira More articles by this author Ramiro Castro-Santamaria More articles by this author Gerald L. Andriole More articles by this author Stephen J. Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...