Use of nonsteroidal anti-inflammatory drugs (NSAIDS), statins, or thiazide diuretics significantly lowers prostate-specific antigen (PSA) levels in men without a history of prostate cancer, new data indicate.
Steven L. Chang, MD, and his associates at Stanford University School of Medicine evaluated the impact of 10 commonly used medications, used singly or in combination, on PSA test readings in men ≥40 years old without prostate cancer. A total of 1864 men who participated in the National Health and Nutrition Examination Survey were included in the study, published online August 2 in the Journal of Clinical Oncology.
The researchers found that use of NSAIDS, statins, or thiazide diuretics was inversely associated with PSA levels. After 1 year, PSA levels were 1%, 3%, and 6% lower, respectively, in men who used these agents s than in men who did not. The differences were more pronounced with prolonged use. At 5 years, PSA levels were lower by 6%, 13%, and 26%, respectively, for users of NSAIDS, statins, or thiazide diuretics than for nonusers. The reduction in PSA levels was greatest in men who used statins and thiazide diuretics—36% after 5 years. Concurrent use of calcium channel blockers minimized or negated the PSA-lowering effect.
The authors note that PSA screening is widely practiced in men >50 years of age, a population with a particularly high rate of medication use. If the lower PSA levels found in men taking commonly used medications results in a delayed diagnosis of prostate cancer, a “medication-adjusted” PSA threshold for prostate cancer screening may be needed, they say.