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The effect of body mass index on PSA levels and the development, screening and treatment of prostate cancer

Nature Clinical Practice Urology volume 4, pages 605–614 (2007)Cite this article

Abstract

The prevalence of both obesity and prostate cancer are increasing in the US. Recently, there has been keen interest in the relationship between obesity and the biology of cancers, including prostate cancer. This article reviews the current literature regarding body mass index (BMI) and its relationship with various clinical aspects of prostate cancer, including its incidence, screening, diagnosis and treatment. Despite several biological mechanisms that potentially link obesity to prostate cancer, the effects of obesity on serum PSA levels and prostate volume, and the subsequent effects on the detection of prostate cancer, are not consistent according to the available literature. Additionally, the epidemiologic data for the incidence of prostate cancer in obese and non-obese populations are conflicting. Treatment of prostate cancer in obese populations is problematic, but data on the ability to overcome these difficulties are unclear. It is difficult to determine whether oncologic and functional outcomes in obese patients differ substantially from those in non-obese patients. Separating the contributions of technical issues from potentially different tumor biologies is not currently possible. Hopefully, the increasing focus on these two highly prevalent health problems might further elucidate their complex relationship.

Key Points

  • PSA levels seem to decrease with increasing BMI in men without evidence of prostate cancer

  • Epidemiologic studies to date do not show a clear association between obesity and the incidence of prostate cancer

  • Obesity seems to increase the risk of biochemical recurrence after radical prostatectomy

  • Despite technical difficulties in treating obese patients, surgical treatment of prostate cancer in obese men seems feasible and results in similar functional outcomes to those in non-obese patients

  • Obese patients might have worse urinary function after radical prostatectomy compared with non-obese patients

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Author information

Authors and Affiliations

  1. TA Skolarus is Chief Resident in the Division of Urology, KY Wolin is Assistant Professor in the Division of Cancer Prevention and Control and RL Grubb III is an Assistant Professor in the Division of Urology at the Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.,

    Ted A Skolarus, Kathleen Y Wolin & Robert L Grubb III

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  1. Ted A Skolarus
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  2. Kathleen Y Wolin
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  3. Robert L Grubb III
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Correspondence to Robert L Grubb III.

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The authors declare no competing financial interests.

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Skolarus, T., Wolin, K. & Grubb, R. The effect of body mass index on PSA levels and the development, screening and treatment of prostate cancer. Nat Rev Urol 4, 605–614 (2007). https://doi.org/10.1038/ncpuro0944

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