PCa Death Decline Tied To Screening

Among white men, high cholesterol levels linked to reduced prostate cancer mortality risk.

ANAHEIM, Calif.—Declines in prostate cancer deaths are associated with an increase in PSA screening, although the effect is greater in white than in black men, according to researchers at the University of Alabama-Birmingham.

The investigators say the weaker association in black men may relate to reduced access to health care and subsequent lower rates of prostate cancer screening.

Prostate cancer mortality rates in the United States increased in the late 1980s, but then started to decline from 1993 through 2003. Researchers obtained from the National Vital Statistic System annual rates of prostate cancer mortality for men aged 50 years and older and analyzed the trend in each of the 50 states for each year from 1993 through 2003.

Annual rates of prostate cancer decline were cross-correlated to the incidence of PSA screening, health insurance coverage, obesity, physical inactivity, high cholesterol, and diabetes. The researchers, who presented findings here at the American Urological Association annual meeting, observed a correlation between prostate cancer mortality and prostate cancer screening in white men, but not black men.

Declining mortality rates for white men were associated with high cholesterol levels and increased PSA screening, whereas declining rates for black men were associated with health insurance coverage. The inverse relationship between declining prostate cancer death rates and high cholesterol in white men was unexpected, according to the researchers.

A possible explanation for this association may be the widespread use of medications used to treat high cholesterol, such as statins, and not with a protective effect of high serum cholesterol.

“Statins have been shown to have an anti-proliferative effect on prostate cancer cells in lab studies, and may be having the same effect on prostate cancer cells in men taking them,” said investigator Janet Colli, MD, assistant professor of surgery at the University of Alabama in Birmingham. 

Dr. Colli said physicians may want to take into account the potential benefits of statins on prostate health when considering whether or not to prescribe these medications.

“This large study gets my attention. The data are more likely to be reliable,” said Anthony Smith, MD, professor and chief of urology at the University of New Mexico Medical School in Albuquerque. “The statins may be playing a visible role in declining prostate cancer rate, but better nutrition, better screening and a combination of things are all playing a role.”