The influence of physical activity on prostate cancer diagnosis: a biopsy cohort analysis
Tubaro A.1, Presicce F.1, Cindolo L.2, Gacci M.3, Leonardo C.4, Cancrini F.1, Bonetto Gambrosier M.1,Carini M.3, Lanciotti M.3,
Pellegrini F.2, Schips L.2, De Nunzio C.1,
1
Sant' Andrea Hospital, "La Sapienza" University of Rome, Dept. of Urology, Rome, Italy, 2Padre Pio Hospital, Dept. of Urology,
Vasto, Italy, 3Careggi Hospital, University of Florence, Dept. of Urology, Florence, Italy, 4"La Sapienza" University of Rome,
Dept. of Urology, Rome, Italy
Introduction & Objectives: A possible relationship between prostate cancer and physical activity has been proposed. The
Physical activity scale for elderly (PASE) questionnaire has been recently proposed to evaluate the association between
physical activity and benign prostatic hyperplasia. Aim of our study was to evaluate the association between physical activit y
and prostate cancer (PCa) risk and grade in a consecutive series of men undergoing prostate biopsy.
Material & Methods: From 2011 onwards, a consecutive men undergoing 12-core prostate biopsy were enrolled into a
prospective database. Indications for a prostatic biopsy were a PSA value ≥ 4 ng/ml and/or a positive digital rectal examination
(DRE). Body mass index (BMI) and waist circumferences were measured before the biopsy. Blood samples were collected
before biopsy and tested for: total PSA, glycemia, HDL, trygliceridemia levels. Blood pressure was recorded. Metabolic
syndrome (MetS) was defined according to the Adult Treatment panel III. PASE questionnaire was colelcted before the biopsy.
Results: 286 patients were enrolled with a median age and PSA of 68 (IQR 62/74) years and 6.1 ng/ml (IQR 5/8.8)
respectively. Median BMI was 26.4 kg/m2 (IQR: 24.6/29); median waist circumference was 102 cm (IQR: 97/108) and 75 pts
(26%) presented a Metabolic syndrome. One-hundred and six patients (37%) had prostate cancer on biopsy. Patients with PCa
presented an higher PSA (6.7 ng/ml, IQR: 5/10 vs 5.6 ng/ml, IQR: 4.8/8; p= 0.007) and a lower PASE score (108, IQR: 66/150
vs 126, IQR 84/198; p=0.005). PASE score inversely correlate with waist circumference (σ: -0.196; p= 0.004) and Age (σ-0.223;
p= 0.0041). On multivariate analysis PASE (OR: 0.996 per unit, 95%CI: 0.993-1.000; p= 0.003) and PSA (1.054 per unit 95%CI:
1.013-1.116, p= 0.04) were the only independent risk factor for prostate cancer diagnosis.
Discussion: In our single center study, a reduced physical activity evaluated by the PASE questionnaire is associated with an
increased risk of prostate cancer on biopsy, although these results should be confirmed in a larger multicenter study.
Conclusions: Even though the molecular pathways are yet to be understood, it is assumable that a reduced physical activity
and the associated metabolic abnormalities should be considered as possible factors involved in prostate cancer pathogenesis.