CORRELATION BETWEEN NSAID USE AND DETECTION RATE IN MEN WHO UNDERWENT PROSTATE BIOPSY. SHOULD WE REDUCE THE PSA CUTOFF FOR MEN IN CHRONIC THERAPY? A MULTICENTER STUDY

You have accessJournal of UrologyCME1 May 2022PD11-01 CORRELATION BETWEEN NSAID USE AND DETECTION RATE IN MEN WHO UNDERWENT PROSTATE BIOPSY. SHOULD WE REDUCE THE PSA CUTOFF FOR MEN IN CHRONIC THERAPY? A MULTICENTER STUDY Francesco Chierigo, Guglielmo Mantica, Farzana Cassim, Rafaela Malinaric, Andrea Benelli, Stefano Parodi, Federico Dotta, Marco Ennas, Martina Beverini, Chiara Vaccaro, Salvatore Smelzo, Francesca Ambrosini, Stefano Tappero, Salvatore Dioguardi, Gioanni Guano, Maro Borghesi, Nazareno Suardi, Carlo Introini, Virginia Varca, Alchiede Simonato, Andrea Gregori, Franco Gaboardi, Andre Van der Merwe, and Carlo Terrone Francesco ChierigoFrancesco Chierigo More articles by this author , Guglielmo ManticaGuglielmo Mantica More articles by this author , Farzana CassimFarzana Cassim More articles by this author , Rafaela MalinaricRafaela Malinaric More articles by this author , Andrea BenelliAndrea Benelli More articles by this author , Stefano ParodiStefano Parodi More articles by this author , Federico DottaFederico Dotta More articles by this author , Marco EnnasMarco Ennas More articles by this author , Martina BeveriniMartina Beverini More articles by this author , Chiara VaccaroChiara Vaccaro More articles by this author , Salvatore SmelzoSalvatore Smelzo More articles by this author , Francesca AmbrosiniFrancesca Ambrosini More articles by this author , Stefano TapperoStefano Tappero More articles by this author , Salvatore DioguardiSalvatore Dioguardi More articles by this author , Gioanni GuanoGioanni Guano More articles by this author , Maro BorghesiMaro Borghesi More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Carlo IntroiniCarlo Introini More articles by this author , Virginia VarcaVirginia Varca More articles by this author , Alchiede SimonatoAlchiede Simonato More articles by this author , Andrea GregoriAndrea Gregori More articles by this author , Franco GaboardiFranco Gaboardi More articles by this author , Andre Van der MerweAndre Van der Merwe More articles by this author , and Carlo TerroneCarlo Terrone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002537.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the PCa detection rate in men with chronic use of Aspirin and to compare it with the detection rate of non-users. We suspect to find a significantly higher detection rate in Aspirin users, due to the reduction of the proportion of PSA that would have been raised due to inflammation. METHODS: After institutional review board approval, we retrospectively collected patients undergoing prostate biopsy over the last 10 years in five institutions. Patients with PSA levels higher than 100 ng/dL, with unknow pathology at prostate biopsy, with Aspirin dosages other than 100mg and with unknown duration of Aspirin therapy were excluded from the analyses. Patients were divided in two groups according to their exposure to Aspirin. Descriptive statistics tested differences in clino-pathological characteristics between the two groups. We relied on multivariable linear and logistic regression models to test whether Aspirin administration was associated with lower PSA values at prostate biopsy, higher prostate cancer diagnosis and higher Gleason Grade Grouping (GGG) at biopsy. RESULTS: We identified 1,059 patients, of whom 803 (76%) did not take Aspirin vs 256 (24%) were taking Aspirin. Patients taking Aspirin were significantly older (72 vs 67 years), were smokers (44 vs 15%), had lower PSA levels (8 vs 7 ng/dL), and had displayed prostatic inflammation at prostate biopsy (48 vs 34%) (all p <0.001). No statistically significant differences in prostate volume, histology (cancer vs non-cancer) and higher GGG (4-5 vs 1-2-3) were recorded. In multivariable loglinear regression analysis, Aspirin administration was associated with lower PSA levels (OR 0.83, 95% CI 0.71-0.97, p=0.01), after controlling for age, prostate volume, smoking history, associated inflammation at prostate biopsy, presence of PCa at biopsy, and GGG. In multivariable logistic regression analysis, Aspirin administration was not found to be a predictor of PCa at prostate biopsy (OR 1.40, 95% CI 0.82-2.40, p=0.21) after controlling for Age, PSA, smoking history, prostate volume, findings at digital rectal examination (DRE) and number of biopsy cores. After controlling for the same variables, in patients with PCa at prostate biopsy (n=516), Aspirin administration was found to predictor of higher GGG (OR 2.24, 95% CI 1.01-4.87, p=0.04). CONCLUSIONS: Our study suggests that Aspirin administration is associated with lower levels of PSA in patients undergoing prostate biopsy. Aspirin administration does not seem to be associated with a higher probability of PCa at prostate biopsy. However, in patient with PCa at prostate biopsy, Aspirin administration was found to be a predictor of more aggressive Gleason Grade Grouping. These findings suggest that a lower PSA threshold should be considered in patients taking Aspirin, as, despite low PSA levels, they might harbour aggressive prostate cancer. Source of Funding: no funding © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e189 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Chierigo More articles by this author Guglielmo Mantica More articles by this author Farzana Cassim More articles by this author Rafaela Malinaric More articles by this author Andrea Benelli More articles by this author Stefano Parodi More articles by this author Federico Dotta More articles by this author Marco Ennas More articles by this author Martina Beverini More articles by this author Chiara Vaccaro More articles by this author Salvatore Smelzo More articles by this author Francesca Ambrosini More articles by this author Stefano Tappero More articles by this author Salvatore Dioguardi More articles by this author Gioanni Guano More articles by this author Maro Borghesi More articles by this author Nazareno Suardi More articles by this author Carlo Introini More articles by this author Virginia Varca More articles by this author Alchiede Simonato More articles by this author Andrea Gregori More articles by this author Franco Gaboardi More articles by this author Andre Van der Merwe More articles by this author Carlo Terrone More articles by this author Expand All Advertisement PDF downloadLoading ...