UroToday - Aspirin is commonly used by men above age 50 for its protective effects towards cardiovascular disease. The risk of prostate cancer increases with age, especially after age 50. If aspirin has protective effect on prostate cancer, it would open another avenue for its use.

Results from this paper suggest that aspirin use seems to be associated with lower PSA values and this effect is much stronger in men who have never smoked as compared to men who have smoked. Despite this strong association with PSA, the lack of association with PSA velocity (marker for prostate cancer progression) is puzzling. It is possible that due to the small sample size and relatively short follow-up time, an association between aspirin use and PSA velocity was not picked up. But it is also possible that aspirin may be affecting PSA without affecting the underlying cancerous process.

Other scientists have noted results similar to this. In a study by Dr. Fowke et al., PSA was significantly lower among aspirin users as compared to non-users, whereas prostate volume was not associated with aspirin use. If this is the case, low PSA values in aspirin users could hinder the diagnosis of prostate cancer especially in men with PSA less that 4 ng/ml. In this study, 26 men had baseline PSA less than or equal to 4 ng/ml. Out of these, 15 men (58%) reported themselves as aspirin users. If aspirin is associated with lower PSA and 4 ng/ml is used as a cut off for conducting prostate biopsy for diagnosis of prostate cancer, approximately 58% of these men could potentially miss being diagnosed for prostate cancer since their PSA values are below 4 ng/ml.

These results have the potential to change clinical practice. This is because if they hold true, aspirin use may prevent accurate measurement of PSA and it may be prudent to ask men taking aspirin to stop taking them for a few days before PSA measurement. However, more studies specifically designed to understand whether aspirin affects only PSA or the underlying disease processes are needed before recommendations can be made.

Amit M. Algotar, 1,2 Patricia A. Thompson, 1,2 James Ranger-Moore, 2 M Suzanne Stratton, 1 C. H. Hsu, 1,2 Frederick R. Ahmann, 1,3 Raymond B. Nagle, 1, 4 and Steven P. Stratton1,3 as part of Beyond the Abstract on UroToday. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations, etc., of their research by referencing the published abstract.

1Arizona Cancer Center. University of Arizona, Tucson, AZ. 2Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ. 3Department of Medicine, University of Arizona, Tucson, AZ. 4Department of Pathology, University of Arizona, Tucson, AZ

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