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Vol. 38. Issue 4.
Pages 232-237 (May 2014)
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Vol. 38. Issue 4.
Pages 232-237 (May 2014)
Original article
DOI: 10.1016/j.acuroe.2013.12.003
Sedentarism and overweight as risk factors for the detection of prostate cancer and its aggressiveness
Sedentarismo y sobrepeso como factores de riesgo en la detección del cáncer de próstata y su agresividad
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J. Morotea,b,??
Corresponding author
jmorote@vhebron.net

Corresponding author.
, A. Celmaa, J. Planasa, J. Placera, C. Konstantinidisa, I. Iztuetaa, I.M. de Torresb,c, M. Olivánd, J. Reventósd,e, A. Dolld,e
a Servicio de Urología, Hospital Vall d’Hebron, Barcelona, Spain
b Departamento de Cirugía, Universitat Autonòma de Barcelona, Barcelona, Spain
c Servicio de Anatomía Patológica, Hospital Vall d’Hebron, Barcelona, Spain
d Unitad de Recerca Biomédica, Hospital Vall d’Hebron, Barcelona, Spain
e Departamento de Fisiología, Universitat Internacional de Catalunya, Barcelona, Spain
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Tables (4)
Table 1. Characteristics of the study population.
Table 2. Analysis of the relation between physical activity (sedentary life vs. activity), BMI (normal vs. overweight), and prostate cancer screening.
Table 3. Analysis of the relation between physical activity (sedentary life vs. activity), BMI (normal vs. overweight), and tumor aggressiveness (high grade and high risk of D’Amico).
Table 4. Binary logistic regression analysis to determine independent predictors of prostate cancer, high-grade tumors, and high-risk tumors.
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Abstract
Objective

To analyze the influence of sedentary (SE) and overweight (OW) in the risk of prostate cancer detection (CP) and aggressiveness.

Materials and methods

We performed prostate biopsy (PB) to 2408 consecutive male, 5 ARIs untreated, because of elevated serum PSA above 4.0ng/mL (91%) or suspicious digital rectal examination (9%). In all ultrasound guided PB, 10 cores were obtained plus 2–8 additionals, according to age and prostate volume. Physical activity was assessed using a survey (SE vs. non-SE) and calculated body mass index (normal vs. OW>25kg/cm2). The tumor aggressiveness was evaluated according to the Gleason score (high grade «HG»: Gleason>7) and D’Amico risk (high risk «HR»: T>3a or PSA>20 or Gleason score>7).

Results

We found a significant association between SE (52.5%) and OW (72.9%); p<0.001. The overall PC detection rate was 35.2%. In men with SE it was 36.7% and non-SE 33.6%, p=0.048. The overall rate of AG tumors was 28.3%, 29.2% in men with SE and 27.1 in non-SE, p=0.261. The overall rate of AR tumors was 35%, 39.7% in men with SE and 29.4% non-SE, p<0.001. CP was detected in 38.1% of men with normal BMI and 34.3% in men with OW, p=0.065. HG tumor rates were 18.1% and 31.4%, respectively, p<0.001 and AR tumor rates were 22.6% and 39.2%, respectively, p<0.001. Binary logistic regression showed that SE was an independent predictor of CP, OR 0.791 (95% CI: 0.625–0.989); p=0.030. SE and OW were independent predictors of HG: OR 0.517 (95% CI: 0.356–0.752); p=0.001, and OR 1.635 (95% CI: 1070–2497); p=0.023. SE and OW were also independent predictors of HR: OR 0.519 (95% CI: 0.349–0.771); p=0.001, and OR 1.998 (95% CI: 1.281–3.115); p=0.002.

Conclusions

In men who met criteria for prostate biopsy an association between sedentary and overweight exist. A sedentary lifestyle is associated with increased risk of PC detection while sedentary and overweight were associated with more aggressive tumors.

Keywords:
Obesity
Physical activity
Prostate cancer
Resumen
Objetivo

Analizar la influencia del sedentarismo (SE) y sobrepeso (SP) en el riesgo de detección de cáncer de próstata (CP) y su agresividad.

Material y método

Se realizó biopsia prostática (BP) a 2.408 varones consecutivos, no tratados con 5ARI, a causa de elevación sérica del PSA por encima de 4,0ng/ml (91%) o tacto rectal sospechoso (9%). En la BP, transrectal y ecodirigida, se obtuvieron 10 cilindros, y entre 2 y 8 adicionales en función de la edad y del volumen prostático. La actividad física se evaluó mediante una encuesta (SE vs. no SE) y se calculó el índice de masa corporal (normal vs. SP:>25kg/cm2). La agresividad tumoral se evaluó según la suma de Gleason (alto grado [AG]: Gleason >7) y el riesgo de D’Amico (alto riesgo [AR]: T>3a o PSA>20 o suma de Gleason>7).

Resultados

Se halló una asociación significativa entre SE (52,5%) y SP (72,9%), p>0,001. La tasa global de detección de CP fue 35,2%. En varones con SE fue 36,7% y en no SE 33,6%, p=0,048. La tasa global de tumores de AG fue 28,3%, 29,2% en varones con SE y 27,1% en no SE, p=0,261. La tasa global de tumores de AR fue 35%, 39,7% en varones con SE y 29,4% en no SE, p<0,001. Se detectó CP en un 38,1% de hombres con IMC normal y 34,3% en hombres con SP, p=0,065. La tasa de tumores de AG fue 18,1 y 31,4% respectivamente, p<0,001, y la tasa de tumores de AR fue 22,6 y 39,2% respectivamente, p<0,001. La regresión logística binaria mostró que el SE fue un predictor independiente de CP, RR 0,791 (95% IC: 0,625-0,989), p=0,030. SE y SP fueron predictores independientes de AG: RR 0,517 (95% IC: 0,356-0,752), p=0,001, y RR 1,635 (95% IC 1,070-2,497), p=0,023. SE y SP también fueron predictores independientes de AR: RR 0,519 (95% IC: 0,349-0,771), p=0,001, y RR 1,998 (95% IC: 1,281-3,115), p=0,002.

Conclusiones

En varones que cumplen criterios de biopsia prostática se encontró una asociación entre sedentarismo y sobrepeso. El sedentarismo se asoció a mayor riesgo de detección de CP, mientras sedentarismo y sobrepeso incrementaron el riesgo de detección de tumores más agresivos.

Palabras clave:
Obesidad
Actividad física
Cáncer de próstata

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