"...increased physical activity...is associated with a reduced risk of prostate cancer..."

BJU Int. 2015 Apr 24. doi: 10.1111/bju.13157. [Epub ahead of print]

Physical activity as a risk factor for prostate cancer diagnosis: a prospective biopsy cohort analysis.

De Nunzio C1, Presicce F, Lombardo R, Cancrini F, Petta S, Trucchi A, Gacci M, Cindolo L, Tubaro A.

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• 1Sant' Andrea Hospital, "La Sapienza" University of Rome, Dept. of Urology, Rome, Italy.

Abstract

OBJECTIVES:

To assess the association between physical activity, evaluated by the Physical activity scale for elderly (PASE) questionnaire, and prostate cancer (PC) risk in a consecutive series of men undergoing prostate biopsy.

MATERIALS AND METHODS:

From 2011 onwards, a consecutive men undergoing 12-core prostate biopsy were enrolled into a prospective database. Indications for a prostatic biopsy were a PSA value ≥ 4 ng/ml and/or a positive digital rectal examination (DRE). 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, HDL, trygliceridemia levels. Blood pressure was recorded. Metabolic syndrome (MetS) was defined according to the Adult Treatment panel III. PASE questionnaire was collected before the biopsy.

RESULTS:

286 patients were enrolled with a median age and PSA of 68 (IQR 62/74) years and 6.1 ng/ml (IQR 5/8.8) respectively. Median BMI was26.4 kg/m2 (IQR: 24.6/29); median waist circumference was 102 cm (IQR: 97/108) and 75 patients (26%) presented a Metabolic syndrome. One-hundred and six patients (37%) had prostate cancer on biopsy. Patients with PC presented an higher PSA (6.7 ng/ml, IQR: 5/10 vs 5.6 ng/ml, IQR: 4.8/8; p= 0.007) and a lower LogPASE score (2.03 (1.82/2.18) vs 2.10 (1.92/2.29); p=0.005). On multivariate analysis, in addition to well-recognized risk factors such as age, PSA, prostate volume, LogPASE score was an independent risk factor for prostate cancer diagnosis (OR: 0.146, 95%CI: 0.037 - 0.577; p= 0.006). Log PASE 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, an increased physical activity evaluated by the PASE questionnaire is associated with a reduced risk of PC and of high-grade prostate cancer on biopsy. Further studies should clarify the molecular pathways behind this association.