Obese men are more likely to be screened for prostate cancer
NEW YORK (Reuters Health) - Men who are obese are more likely than normal weight men to be screened for prostate cancer, according to a new study.
"Obesity is associated with more advanced disease and worse outcomes in men with prostate cancer," Dr. Judd W. Moul and colleagues from Duke University Medical Center, Durham, N.C., write in the February issue of 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 used data from the 2002 Behavioral Risk Factor Surveillance System. Included in the analysis were 57,827 men at least 40 years of age. Primary outcome measures included the proportion of men ever screened for prostate cancer and the proportion screened within the last year.
The respondents had a mean age of 55.4 years. Forty-eight percent of the subjects were overweight and 24.9% were obese. Overall, 88.6% of the men reported having health insurance and 82.3% reported having at least one personal physician. Nearly 60% of the subjects reported ever having a prostate specific antigen (PSA) test and 42.0% reported having a PSA test in the last year.
Overall, 62.1% of obese men ever had a PSA test, compared with 56.1% of normal weight men (p < 0.001). Obese men were also more likely to have had a PSA test in the past year compared to normal weight men (44.2% versus 38.2%, p < 0.001). Obese men remained more likely than normal weight men to have ever had a PSA test (OR 1.37) and to have had a PSA test in the last year (OR 1.82) after controlling for sociodemographic characteristics.
Men who had an ongoing relationship with a physician (OR 2.95) and black non-Hispanic men (OR 1.58) were also more likely to have had a PSA test in the last year.
"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," Moul's team writes. "Further investigation is required to confirm our findings and explain differences in prostate cancer outcomes in obese men."
J Urol 2007;177:493-498.