PSA concentrations are higher in men who engage in more sedentary behavior and lower levels of light physical activity, a study found.

In an analysis of data from the 2003-2004 or 2005-2006 National Health and Nutrition Examination Survey cycles, researchers found that for each one-hour increase in sedentary behavior, men were 16% more likely to have an elevated PSA level, defined as a level of 4 ng/mL or higher, according to a report in Mayo Clinic Proceedings (2013;88:11-21). In addition, for each one-hour increase in light physical activity, men were 18% less likely to have an elevated PSA level.

The study included 1,672 NHANES participants who were asked to wear an accelerometer—a device that measures the frequency, intensity, and duration of physical activity—on their right hip for seven days. The men were asked to wear the device during all activities except water-based activities and while sleeping.

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The investigators, Paul D. Loprinzi, PhD, of Bellarmine University in Louisville, Ky., and Manish Kohli, MD, of Mayo Clinic in Rochester, Minn., noted that there are compelling reasons to believe that physical activity may have a causative role in decreasing PSA level and possibly prostate cancer (PCa) risk.

“It is hypothesized that regular participation in physical activity may reduce prostate cancer risk through a variety of biological mechanisms including changes in energy balance, immune function, inflammation, antioxidant defenses, and endogenous hormones,” they wrote.

Drs. Loprinzi and Kohli said their findings have implications for PSA-based screening for PCa. They noted that clinical factors already known to alter PSA measurements include inflammation or infection of the prostate or use of medications such as 5-alpha reductase inhibitors. Thus, these factors are considered when interpreting a PSA test result and before initiating a urologic workup because of an “elevated” PSA level.

Based on their results, the authors stated, evaluation of a patient’s physical activity and sedentary level before PSA testing also is important because these factors also may influence measurements and lead to a urologic diagnostic workup.