Abstract:
BACKGROUND
Prostate cancer (PC) detection with the PC screening marker prostate-specific antigen (PSA) is an opportunistic event in New Zealand (NZ). PSA levels have been implicated in PC under and over-diagnosis due to a postulated association with lifestyle factors and genetic polymorphisms.
OBJECTIVES
1) Define the status of clinical & histopathological parameters and
2) Clarify their association with lifestyle factors and genetic polymorphisms in PC patients undergoing radical prostatectomy (RP)
METHODS
• Design: Medical & histological records of PC patients managed with RP in Auckland (NZ) were retrospectively reviewed.
• Data extraction: Demographic, lifestyle (smoking & alcohol consumption), aldo-keto reductase 1C3 (AKR1C3) rs12529 genotype, clinical and post-RP histological data were extracted.
• Analysis: Clinical and histological parameters were compared with and without stratification based on lifestyle factors and AKR1C3 rs12529 genotype.
RESULTS
A total of 134 PC patients managed with RP were included. PC under and over-diagnosis were recorded in 56.7% & 9.0% of patients, respectively. Tobacco smoking (p=0.25), alcohol consumption (p=0.80), and AKR1C3 rs12529 genotype (CC vs. CG+GG) (p=0.77) did not impact on the diagnosis status (under-/over-diagnosis). There were no significant differences in demographic, clinical & histological parameters between patients when stratified by AKR1C3 rs12529 genotype (CC vs. combined CG+GG). Ever-smoking was significantly associated with both maximum serum PSA level and PSA density (PSAD). Alcohol consumption was associated with serum maximum PSA level and maximum tumor diameter (MTD).
CONCLUSIONS
High rates of PC underdiagnosis are a significant issue in the current RP cohort.
The observed association between lifestyle factors and maximum PSA at diagnosis, PSAD, and MTD may contribute to the high rates of under-diagnosis and requires further investigation.
