Effects of common medications on likelihood of prostate cancer diagnosis
Posted Aug 09 2010 12:00am
It has been known for a while that statins and nonsteroidal anti-inflammatory drugs (NSAIDs) can affect PSA levels. A new paper now opens the question of whether men who take these and/or other drugs for significant time periods are at risk for a “missed” diagnosis of prostate cancer.
Chang et al.analyzed data from men of 40 or more years of age who did not have prostate cancer from the 2003 to 2004 and 2005 to 2006 cycles of the National Health and Nutrition Examination Survey (NHANES). They excluded all men with recent prostate manipulation, prostatitis, and those on hormone therapy. Their goal was to identify effects on PSA levels associated with short- and long-term use of the 10 most commonly prescribed classes of medication.
The results of their study showed that:
1,864 men met the inclusion criteria for their analysis.
Regular use of NSAIDs, statins, and thiazide diuretics was inversely related to PSA levels.
Use of an NSAID, a statin, or a thiazide diuretic for a period of 5 years was associated with reduction in PSA levels by 6, 13, and 26 percent, respectively.
Use of statins together with thiazide diuretics showed the greatestreduction in PSA levels: 36 percent after 5 years.
Concurrent use of a calciumchannel blocker minimizes or negates the inverse relationship of statin use and PSA level.
The authors conclude that use of NSAIDs, statins, and thiazide diureticscan reduce PSA levels by clinically relevant amounts but that theimpact of regularly consuming these common medications on individual test results for risk of prostate cancer is unknown.
An article on the HealthDay web site also addresses these data. It is clear that these types of drug are very commonly being used by men > 50 years of age who are at elevated risk for prostate cancer, but it is not clear (yet) how to interpret PSA data in such men.