Arizona Cancer Center. University of Arizona, Tucson, AZ.Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ; Department of Medicine, University of Arizona, Tucson, AZ; Department of Pathology, University of Arizona, Tucson, AZ.
Current diagnostic tools are inadequate for reliable prediction of prostate cancer (PCa) aggressiveness in patients with localized disease. This results in many patients being exposed to potentially unnecessary invasive treatment and its associated morbidities. In order to develop appropriate treatment strategies, it is essential to understand the differences between patients who will develop aggressive disease and those who won't.
A longitudinal study was conducted in men with localized PCa on active surveillance for their disease in which 140 subjects were followed every 3 months for up to 5 years. Change in prostate specific antigen (PSA) over time (PSA velocity) was used as marker for PCa progression. Subjects were categorized as slow, intermediate and fast progressors based on tertiles of PSA velocity. Differences in baseline markers were investigated using logistic regressions. Two approaches were used, slow progressors were compared to fast progressors (model 1) and slow progressors were compared to combination of intermediate and fast progressors (model 2).
Aspirin was negatively associated with high PSA velocity in model 1 (Odds Ratio[95% Confidence Interval]: 0.24 (0.06, 0.94), p-value = 0.04) and model 2 (OR = 0.22(0.08, 0.59), p-value = 0.003). Whereas smoking was positively associated with high PSA velocity in model 1 (1.03 (0.92, 1.13), p-value = 0.01).
These findings highlight the role of aspirin and smoking in PCa progression. They have potential towards risk stratification as well as PCa prevention and hence need to be investigated further.
Algotar AM, Thompson PA, Ranger-Moore J, Stratton MS, Hsu CH, Ahmann FR, Nagle RB, Stratton SP. Are you the author?
Reference: Intern Med J. 2011 Mar 14. Epub ahead of print.