Obesity and prostate cancer screening among African-American and Causian men

Jay Fowke, Lisa B. Signorello, Willie Underwood, Flora A.M. Ukoli, William J. Blot

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

BACKGROUND. Differential prostate-specific antigen (PSA) testing practices according to obesity-related comorbid conditions may contribute to inconsistent results in studies of obesity and prostate cancer. We investigated the relationship between obesity and PSA testing, and evaluated the role of prior diagnoses and disease screening on PSA testing patterns. METHODS. Men, 40 and 79 years old and without prior prostate cancer were recruited from 25 health centers in the Southern US (n = 11,558, 85% African-American). An extensive in-person interview measured medical and other characteristics of study participants, including PSA test histories, weight, height, demographics, and disease history. Odds ratios (OR) and (95% confidence intervals) from logistic regression summarized the body mass index (BMI) and PSA test association while adjusting for socio-economic status (SES). RESULTS. BMI between 25 and 40 was significantly associated with recent PSA testing (past 12 months) (OR 25.0-29.9 = 1.23 (1.09, 1.39); OR30-34.9 = 1.36 (1.18, 1.57); OR35.0-39.9 = 1.44 (1.18, 1.76); OR≥40 = 1.15 (0.87, 1.51)). Prior severe disease diagnoses, such as heart disease, did not influence the obesity and PSA test association. However, adjustment for prior high blood pressure or high cholesterol diagnoses reduced the BMI-PSA testing associations. Physician PSA test recommendations were not associated with BMI, and results did not appreciably vary by race. CONCLUSIONS. Overweight and obese men were preferentially PSA tested within the past 12 months. BMI was not associated with physician screening recommendations. Data suggest that clinical diagnoses related to obesity increase clinical encounters that lead to preferential selection of obese men for prostate cancer diagnosis. This detection effect may bias epidemiologic investigations of obesity and prostate cancer incidence.

Original languageEnglish (US)
Pages (from-to)1371-1380
Number of pages10
JournalProstate
Volume66
Issue number13
DOIs
StatePublished - Sep 13 2006
Externally publishedYes

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Prostate-Specific Antigen
Early Detection of Cancer
African Americans
Prostatic Neoplasms
Obesity
Body Mass Index
Odds Ratio
Physicians
Heart Diseases
Logistic Models
Cholesterol
Economics
Demography
Confidence Intervals
Interviews
Hypertension
Weights and Measures
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

Fowke, J., Signorello, L. B., Underwood, W., Ukoli, F. A. M., & Blot, W. J. (2006). Obesity and prostate cancer screening among African-American and Causian men. Prostate, 66(13), 1371-1380. https://doi.org/10.1002/pros.20377

Obesity and prostate cancer screening among African-American and Causian men. / Fowke, Jay; Signorello, Lisa B.; Underwood, Willie; Ukoli, Flora A.M.; Blot, William J.

In: Prostate, Vol. 66, No. 13, 13.09.2006, p. 1371-1380.

Research output: Contribution to journalArticle

Fowke, J, Signorello, LB, Underwood, W, Ukoli, FAM & Blot, WJ 2006, 'Obesity and prostate cancer screening among African-American and Causian men', Prostate, vol. 66, no. 13, pp. 1371-1380. https://doi.org/10.1002/pros.20377
Fowke J, Signorello LB, Underwood W, Ukoli FAM, Blot WJ. Obesity and prostate cancer screening among African-American and Causian men. Prostate. 2006 Sep 13;66(13):1371-1380. https://doi.org/10.1002/pros.20377
Fowke, Jay ; Signorello, Lisa B. ; Underwood, Willie ; Ukoli, Flora A.M. ; Blot, William J. / Obesity and prostate cancer screening among African-American and Causian men. In: Prostate. 2006 ; Vol. 66, No. 13. pp. 1371-1380.
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abstract = "BACKGROUND. Differential prostate-specific antigen (PSA) testing practices according to obesity-related comorbid conditions may contribute to inconsistent results in studies of obesity and prostate cancer. We investigated the relationship between obesity and PSA testing, and evaluated the role of prior diagnoses and disease screening on PSA testing patterns. METHODS. Men, 40 and 79 years old and without prior prostate cancer were recruited from 25 health centers in the Southern US (n = 11,558, 85{\%} African-American). An extensive in-person interview measured medical and other characteristics of study participants, including PSA test histories, weight, height, demographics, and disease history. Odds ratios (OR) and (95{\%} confidence intervals) from logistic regression summarized the body mass index (BMI) and PSA test association while adjusting for socio-economic status (SES). RESULTS. BMI between 25 and 40 was significantly associated with recent PSA testing (past 12 months) (OR 25.0-29.9 = 1.23 (1.09, 1.39); OR30-34.9 = 1.36 (1.18, 1.57); OR35.0-39.9 = 1.44 (1.18, 1.76); OR≥40 = 1.15 (0.87, 1.51)). Prior severe disease diagnoses, such as heart disease, did not influence the obesity and PSA test association. However, adjustment for prior high blood pressure or high cholesterol diagnoses reduced the BMI-PSA testing associations. Physician PSA test recommendations were not associated with BMI, and results did not appreciably vary by race. CONCLUSIONS. Overweight and obese men were preferentially PSA tested within the past 12 months. BMI was not associated with physician screening recommendations. Data suggest that clinical diagnoses related to obesity increase clinical encounters that lead to preferential selection of obese men for prostate cancer diagnosis. This detection effect may bias epidemiologic investigations of obesity and prostate cancer incidence.",
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N2 - BACKGROUND. Differential prostate-specific antigen (PSA) testing practices according to obesity-related comorbid conditions may contribute to inconsistent results in studies of obesity and prostate cancer. We investigated the relationship between obesity and PSA testing, and evaluated the role of prior diagnoses and disease screening on PSA testing patterns. METHODS. Men, 40 and 79 years old and without prior prostate cancer were recruited from 25 health centers in the Southern US (n = 11,558, 85% African-American). An extensive in-person interview measured medical and other characteristics of study participants, including PSA test histories, weight, height, demographics, and disease history. Odds ratios (OR) and (95% confidence intervals) from logistic regression summarized the body mass index (BMI) and PSA test association while adjusting for socio-economic status (SES). RESULTS. BMI between 25 and 40 was significantly associated with recent PSA testing (past 12 months) (OR 25.0-29.9 = 1.23 (1.09, 1.39); OR30-34.9 = 1.36 (1.18, 1.57); OR35.0-39.9 = 1.44 (1.18, 1.76); OR≥40 = 1.15 (0.87, 1.51)). Prior severe disease diagnoses, such as heart disease, did not influence the obesity and PSA test association. However, adjustment for prior high blood pressure or high cholesterol diagnoses reduced the BMI-PSA testing associations. Physician PSA test recommendations were not associated with BMI, and results did not appreciably vary by race. CONCLUSIONS. Overweight and obese men were preferentially PSA tested within the past 12 months. BMI was not associated with physician screening recommendations. Data suggest that clinical diagnoses related to obesity increase clinical encounters that lead to preferential selection of obese men for prostate cancer diagnosis. This detection effect may bias epidemiologic investigations of obesity and prostate cancer incidence.

AB - BACKGROUND. Differential prostate-specific antigen (PSA) testing practices according to obesity-related comorbid conditions may contribute to inconsistent results in studies of obesity and prostate cancer. We investigated the relationship between obesity and PSA testing, and evaluated the role of prior diagnoses and disease screening on PSA testing patterns. METHODS. Men, 40 and 79 years old and without prior prostate cancer were recruited from 25 health centers in the Southern US (n = 11,558, 85% African-American). An extensive in-person interview measured medical and other characteristics of study participants, including PSA test histories, weight, height, demographics, and disease history. Odds ratios (OR) and (95% confidence intervals) from logistic regression summarized the body mass index (BMI) and PSA test association while adjusting for socio-economic status (SES). RESULTS. BMI between 25 and 40 was significantly associated with recent PSA testing (past 12 months) (OR 25.0-29.9 = 1.23 (1.09, 1.39); OR30-34.9 = 1.36 (1.18, 1.57); OR35.0-39.9 = 1.44 (1.18, 1.76); OR≥40 = 1.15 (0.87, 1.51)). Prior severe disease diagnoses, such as heart disease, did not influence the obesity and PSA test association. However, adjustment for prior high blood pressure or high cholesterol diagnoses reduced the BMI-PSA testing associations. Physician PSA test recommendations were not associated with BMI, and results did not appreciably vary by race. CONCLUSIONS. Overweight and obese men were preferentially PSA tested within the past 12 months. BMI was not associated with physician screening recommendations. Data suggest that clinical diagnoses related to obesity increase clinical encounters that lead to preferential selection of obese men for prostate cancer diagnosis. This detection effect may bias epidemiologic investigations of obesity and prostate cancer incidence.

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