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Physical activity as a risk factor for prostate cancer diagnosis: a prospective biopsy cohort analysis
Author(s) -
De Nunzio Cosimo,
Presicce Fabrizio,
Lombardo Riccardo,
Cancrini Fabiana,
Petta Stefano,
Trucchi Alberto,
Gacci Mauro,
Cindolo Luca,
Tubaro Andrea
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13157
Subject(s) - medicine , prostate cancer , interquartile range , rectal examination , biopsy , body mass index , prostate biopsy , waist , prospective cohort study , prostate specific antigen , metabolic syndrome , prostate , urology , cancer , gastroenterology , obesity
Objectives To assess the association between physical activity, evaluated by the Physical Activity Scale for the Elderly ( PASE ) questionnaire, and prostate cancer risk in a consecutive series of men undergoing prostate biopsy. Patients and Method From 2011 onwards, consecutive men undergoing 12‐core prostate biopsy were enrolled into a prospective database. Indications for a prostatic biopsy were a prostate‐specific antigen ( PSA ) value of ≥4 ng/ mL and/or a positive digital rectal examination. Body mass index ( BMI ) and waist circumferences were measured before the biopsy. Fasting blood samples were collected before biopsy and tested for: total PSA , glucose, high‐density lipoprotein cholesterol, and trygliceride levels. Blood pressure was recorded. Metabolic syndrome (MetS) was defined according to the Adult Treatment panel III . The PASE questionnaire was completed before the biopsy. Results In all, 286 patients were enrolled with a median (interquartile range, IQR ) age and PSA level of 68 (62–74) years and 6.1 (5–8.8) ng/ mL , respectively. The median ( IQR ) BMI was 26.4 (24.6–29) kg/m 2 and waist circumference was 102 (97–108) cm, with 75 patients (26%) presenting with MetS. In all, 106 patients (37%) had prostate cancer at biopsy. Patients with prostate cancer had higher PSA levels (median [ IQR ] 6.7 [5–10] vs 5.6 [4.8–8] ng/ mL ; P = 0.007) and lower Log PASE scores (median [ IQR ] 2.03 [1.82–2.18] vs 2.10 [1.92–2.29]; P = 0.005). On multivariate analysis, in addition to well‐recognised risk factors such as age, PSA level and prostate volume, Log PASE score was an independent risk factor for prostate cancer diagnosis (odds ratio [ OR ] 0.146, 95% confidence interval [ CI ] 0.037–0.577; P = 0.006]. Log PASE score was also an independent predictor of high‐grade cancer ( OR 0.07, 95% CI 0.006–0.764; P = 0.029). Conclusion In our single‐centre study, increased physical activity, evaluated by the PASE questionnaire, is associated with a reduced risk of prostate cancer and of high‐grade prostate cancer at biopsy. Further studies should clarify the molecular pathways behind this association.