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Aspirin May Lower PSA Levels in Men

But anti-inflammatory drugs may mask evidence of prostate cancer

November 18, 2008

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Daily aspirin has long been suggested for some people at risk of heart trouble. Now, researchers at Vanderbilt University say aspirin and other non-steroidal anti-inflammatory drugs is significantly associated with lower prostate-specific antigen (PSA) levels, especially among men with prostate cancer.

That could be a good thing -- or a not-so-good thing.

"There are several ways to consider the impact of these results," said Dr. Jay Fowke, the study's lead investigator. "Several prior studies reported anti-inflammatory drugs like NSAIDs were associated with lower prostate cancer risk. Our data also suggest that NSAID use has a beneficial effect on prostate cancer. These findings could be consistent with a protective effect, because aspirin reduced PSA levels more among those men who were diagnosed with prostate cancer than among men with other prostate diseases."

However, these data also indicate that NSAID use could affect doctors' ability to detect prostate cancer, regardless of any reduction in prostate cancer risk.

"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, use of these agents could be hampering our ability to detect early-stage prostate cancer through PSA screening," Fowke said.

This large analysis known as the Nashville Men's Health Study included 1,277 participants referred to a urologist for a biopsy of their prostate. Approximately 46 percent of the men reported taking an NSAID, mostly aspirin.

After adjusting for age, race, family prostate cancer history, obesity, and other variables that have independent effects on the size of the prostate organ, cancer risk, and PSA levels, the researchers found that aspirin use was significantly associated with lower PSA levels.

PSA levels were nine percent lower in men taking aspirin, the NSAID most commonly used, compared with men who did not use aspirin, say the researchers. A PSA test is used widely as a method to screen men for the possibility of prostate cancer, with higher blood PSA levels suggesting a greater chance of having prostate cancer. High PSA levels can also signify benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate organ.

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