Obesity may be obstacle in diagnosing prostate cancer

Obesity may make it more difficult to detect prostate cancer, leading to delayed diagnosis and putting some men at greater risk of death, according to a multicenter study. With larger prostate glands seen among obese men, physicians may be 20% to 25% less likely to identify prostate cancer when it's present, said lead author Stephen Freedland, MD, of Duke University Medical Center.

The study, published in the Journal of Urology (2006; 175:500-4), included a review of medical records of 1,400 men diagnosed with prostate cancer who had undergone radical prostatectomy. Results suggested the greatest increases in prostate size were among the 245 younger men who had a body mass index between 30 and 34.9, roughly 17% of the study population.

"The majority of men diagnosed with prostate cancer are still in their 60s and 70s, but we're starting to find more and more men in their 50s who are presenting with the disease," Dr. Freedland said. "These results indicate a big decrease in diagnosis for those younger obese men."

The researchers said they are not yet advocating that physicians begin screening obese men at a younger age. They are, however, recommending aggressive screening, including digital rectal exam and a serum PSA measurement, when such men are examined. They also noted that other studies have shown that PSA levels are lower among obese men and thus what is "abnormal" in an obese man may be different from a normal weight man.