Body Mass Index and Age Correlation with Prostate-specific Antigen Density as Prostate Cancer Risk Indicators in a Screened Male University Population in Nigeria: A Pilot Study

Background: Prostate-specific antigen density (PSAD) is one of the means of improving PSA sensitivity as a marker of a prostate cancer diagnosis. However, this ability is perceived to be obscured by certain factors such as high body mass index and age in Caucasian and western populations, which tends to reduce its sensitivity and lead to misclassification of at-risk patients for prostate cancer. Aim: We studied the correlation of body mass index (BMI) and age with prostate-specific antigen density (PSAD) as indicators of prostate cancer risk in a screened male population(40 years and above) in the University of Calabar, Nigeria. Study Design: A cross-sectional analytical study with consecutive participant recruitment. Place and Duration of Study: The study was carried out in the University of Calabar Medical centre during a medical outreach. Materials and Methods: The study involved sixty-one (61) healthy male participants. BMI was mathematically determined from the weight and height and was categorized as underweight, normal weight, overweight and obesity based on the WHO classification with values of <18.5, 18.5-24.9, 25.0-29.9, and ≥30 (Kg/m2) respectively. Blood samples were collected and analyzed for PSA and transrectal ultrasound scan was done to estimate the prostate volume and was used to calculate the prostate-specific antigen density. Results: Over 67% of participants had PSA values below 4.0 ng/ml, 14.8% between 4.0-10.0 ng/ml, and 18% above 10.0 ng/ml. Body mass index (BMI) assessment revealed that 1.6% of the sampled population had BMI <18.5 Kg/m2, 32.8% had BMI between 18.5 Kg/m2 and 24.9 Kg/m2, while 50.8% were noticed to have a BMI of between 25.0 Kg/m2 and 29.9 Kg/m2, and 14.8% had BMI of 30 Kg/m2 and above. Conclusion: There was an inverse correlation of BMI with prostate-specific antigen density (PSAD) and a direct correlation of age with PSAD in this study of Nigerian men.