NEW YORK (Reuters Health) Jun 23 - Nonsteroidal anti-inflammatory drugs (NSAIDs) may affect prostate cancer detection, according to Tennessee-based researchers.
Dr. Jay H. Fowke of Vanderbilt University Medical Center, Nashville, and colleagues studied 1277 men who had diagnostic prostate biopsies. About 46% were receiving NSAIDs. Most used aspirin, with only 3.5% using other agents such as celecoxib.
Prostate volume was similar between aspirin users and non-users, but mean prostate specific antigen (PSA) levels were significantly lower in aspirin users (7.3 ng/mL) than in non-users (8.0 ng/mL).
The association between PSA and aspirin use was significant in men with latent prostate cancer, marginal in those with high grade prostatic intraepithelial neoplasia, and nonsignificant in men with negative biopsies. The strongest association was in men with cancer and a prostate volume of 60 mL or more. In this subset, mean PSA levels were 7.3 in aspirin users vs 12.7 in nonusers (p<0.01).
"This analysis," Dr. Fowke told Reuters Health, "raises the concern that aspirin and other NSAIDs may lower PSA levels below the level of clinical suspicion without having any effect on prostate cancer development, and if that is true, use of these agents could be hampering our ability to detect early-stage prostate cancer through PSA screening."
"Several prior studies reported anti-inflammatory drugs like NSAIDs were associated with lower prostate cancer risk," Dr. Fowke said. "Our data...could be consistent with a protective effect, because aspirin reduced PSA levels more among those men who were diagnosed with prostate cancer than among men with other prostate diseases."
J Urol 2009;181:2064-2070.
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