Association Of Nonsteroidal Anti-Inflammatory Drugs, Prostate Specific Antigen And Prostate Volume

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 10 Aug 2009 - 1:00 PDT

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UroToday.com - A group of investigators from Vanderbilt University investigated the link between nonsteroidal anti-inflammatory drugs (NSAID), PSA and prostate volume. Their findings appear in the May, 2009 issue of the Journal of Urology. NSAIDs such as aspirin inhibit COX activity, which are rate limiting in the conversion of arachidonic acid to PGE2. PGE2 is known to increase cell proliferation in prostate tissue.

The study cohort included 1,277 men scheduled for prostate biopsy between 2002 and 2008. Clinical and pathological data was gathered, prostate volume measured on transrectal ultrasound, a family history acquired, and medications recorded. Prescription and non-prescription NSAIDs were abstracted form the medical records

NSAID use was reported in 586 men (45.9%) and aspirin was the most common NSAID used. Factors associated with NSAID use included increasing age, higher BMI, and white race. NSAID use was also significantly associated with medication for hyperlipidemia and cardiovascular disease. It was marginally associated with medication for diabetes and not associated with receiving a steroid reductase inhibitor or with cancer grade at biopsy. PSA was 9% lower in aspirin vs. non-aspirin users after adjusting for age, race, family history biopsy outcomes and BPH treatments.

These differences in PSA were still present after adjusting for obesity and treatment for other conditions and prostate volume. Prostate volume was not significantly associated with NSAID use. PSA was lower with aspirin use regardless of age; however differences in PSA associated with aspirin use were significant in men with latent cancer, marginal in patients with PIN and negligible in men with negative biopsy. PSA was lower in aspirin users with a prostate volume of greater than 60ml, but not in men with a volume of between 40 and 60 ml. Overall, PSA was about 9% lower in men on aspirin.

Fowke JH, Motley SS, Smith JA Jr, Cookson MS, Concepcion R, Chang SS, Byerly S
J Urol. 2009 Mar 13. Epub ahead of print.
doi:10.1016/j.juro.2009.01.031

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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