Body mass index, prostate volume and health condition are associated with the risk of prostate cancer detectionin a biopsy population

Purpose: Ultrasound-guided biopsy is the standard method for diagnosing prostate cancer. However, according to the literature, the positive predictive value of prostate biopsy is very low when PSA < 30 ng/mL. We assessed the association of prostate cancer detection rates with age, prostate volume, and health condition in a referral-based biopsy population when PSA < 30 ng/mL. Materials and methods: We retrospectively reviewed the records of 546 men who underwent prostate biopsy at Shanghai Tenth People's Hospital with a total PSA of 4 to 30 ng/mL. The age, body mass index, biopsy results, and health condition including diabetes mellitus, hypertension, and other chronic diseases were collected. Cancer detection rates with respect to age, body mass index, and health condition were analyzed. Results: A total of 546 patients were included in the analysis. The mean age was 71.1 years, and the median PSA level was 14.7 ng/mL. Prostate cancer was detected from the biopsy in 198 patients (36.26%). A higher prostate cancer detection rate was found in obese patients than in normal patients (81% vs 16.7%). No significant difference was found for age and the odds of being diagnosed with prostate cancer (P = 0.211). However, patients with prostate volume < 50 cc had a higher prostate cancer detection rate than patients with prostate volume > 50 cc (49.1% vs. 13.3%). Our data also indicated that DM and hypertension are risk factors for the development of prostate cancer. Logistic analysis showed that prostate nodules, BMI, PSA, and prostate volume were the significant predictors of a positive biopsy. Conclusion: BMI, prostate volume, DM, and hypertension were associated with an increased prostate cancer detection rate. However, age did not affect the rate of prostate cancer biopsy detection.