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Aspirin and other NSAIDs use may lower PSA levels and mask prostate cancer risk

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Regular use of aspirin and other NSAIDs may lower PSA levels and mask the development of prostate cancer, suggest US researchers.

They have found that regular use of aspirin and other NSAIDs appear to lower levels of prostate-specific antigen – the traditional marker for prostate cancer and benign prostatic hyperplasia. The team from Vanderbilt University, Tennessee, looked at data on 1,277 men who had been referred to a urologist for a prostate biopsy.

Just under half the men, 46%, reported taking an NSAID ‘regularly’, of which 37% took aspirin. After adjusting for other factors, such as prostate size, the authors found that PSA levels were 9% lower in men who took aspirin compared with those who did not.

They suggest the results could be interpreted in two ways: that NSAIDs may have a protective effect against prostate cancer or that the drugs could affect the ability to detect cancer, regardless of any risk reduction.

‘This analysis raises the concern that aspirin and other NSAIDs may lower PSA levels below the level of clinical suspicion without having any effect on prostate cancer development and, if that is true, these agents could be hampering our ability to detect early stage prostate cancer through PSA screening,’ said the authors at an American Association for Cancer Research conference in Washington last week.

‘It will be important to understand which mechanism is in play because many men take NSAIDs for their cardiovascular health,’ they added.

Ingrid Spickett, helpline nurse manager at the Prostate Cancer Charity, agreed that further research was needed to clear up ‘uncertainty’ over the findings.

‘This interesting study does not suggest men should start taking aspirin regularly to reduce their risk of prostate cancer, nor does it tell the many thousands of men who already take regular aspirin for other reasons to stop,’ she said.

Is PSA still the best indicator of prostate cancer risk?

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