INTRODUCTION: The occurrence of lower prostate-specific antigen (PSA) levels in overweight White and African American men has been studied, but there is no data regarding Hispanics, which have a higher mortality rate from Prostate Cancer (PCa) than Whites. The objective of this study was to investigate if being overweight could affect both the sensitivity of the PSA as a diagnostic tool and the progression of PCa in this group.

METHODS: Retrospective study of records from 400 patients that underwent testing for PCa during 2005 and 400 patients under treatment for PCa from 2003-2005 at the urology clinics of the Veterans Administration Caribbean Healthcare System. Accrued data included body mass index (BMI), age, PSA levels, biopsy results, and cancer status after treatment.

RESULTS: In men, with normal age adjusted PSA levels, overweight and obese men had 35.38% and 38.13%, respectively, positive biopsies while men with normal BMI had 26.15%. In addition, 73.84% of overweight men over 61 years old with normal PSA were positive for prostate cancer. There is a statistically significant decrease in PSA sensitivity from 71.7 (95% CI: 58.6-82.5) in men with normal BMI to 55.4 (95% CI: 41.5-68.7) in obese men (P = .015). In multivariate analysis, patients with a BMI over 25 kg/m2 had a 2.63 (CI 95%: 1.23-5.64) fold higher risk of metastases than those with normal BMI.

CONCLUSIONS: in overweight Hispanic men the PSA level is a less sensitive marker for PCa and those individuals with higher BMI have higher prevalence of metastatic disease.