Sedentarismo y sobrepeso como factores de riesgo en la detección del cáncer de próstata y su agresividad

Abstract

ObjectiveTo analyze the influence of sedentary (SE) and overweight (OW) in the risk of prostate cancer detection (CP) and aggressiveness. Material and methodWe performed prostate biopsy (PB) to 2,408 consecutive male, 5ARIs untreated, because of elevated serum PSA above 4.0ng/mL (91%) or suspicious digital rectal examination (9%). In all ultrasound guided PB, 10 cores were obtained plus 2 to 8 additionals, according to age and prostate volume. Physical activity was assessed using a survey (SE vs non-SE) and calculated body mass index (normal vs OW> 25kg/cm2). The tumor aggressiveness was evaluated according to the Gleason score (high grade «HG»: Gleason> 7) and D’Amico risk (high risk «HR»: T>3a or PSA>20 or Gleason score>7). ResultsWe found a significant association between SE (52.5%) and OW (72.9%), P<.001. The overall PC detection rate was 35.2%. In men with SE it was 36.7% and non-SE 33.6%, P=.048. The overall rate of AG tumors was 28.3%, 29.2% in men with SE and 27.1 in non-SE, P=.261. The overall rate of AR tumors was 35%, 39.7% in men with SE and 29.4% non-SE, P<.001. CP was detected in 38.1% of men with normal BMI and 34.3% in men with OW, P=.065. HG tumor rates were 18.1% and 31.4% respectively, P<.001 and AR tumor rates were 22.6% and 39.2% respectively, P<.001. Binary logistic regression showed that SE was an independent predictor of CP, OR .791 (95% CI: .625-.989), P=.030. SE and OW were independent predictors of HG: OR .517 (95% CI: .356-.752), P=.001, and OR 1.635 (95% CI: 1070-2497), p=0.023. SE and OW were also independent predictors of HR: OR .519 (95% CI .349-.771), P=.001, and OR 1.998 (95% CI 1.281-3.115), P=.002. ConclusionsIn men who met criteria for prostate biopsy an association between sedentary and overweight exist. A sedentary lifestyle is associated with increased risk of PC detection while sedentary and overweight were associated with more aggressive tumors.