Background Studies suggest obesity is associated with decreased prostate cancer risk. We hypothesized obesity is biologically associated with increased risk, though this is obscured due to hemodilution of PSA and larger prostate size. Methods Retrospective study of 441 consecutive men undergoing prostate biopsy between 1999 and 2003 at two equal access centers. The association between obesity (body mass index ≥30 kg/m2) and positive biopsy and Gleason ≥4+3 were estimated using logistic regression analysis adjusting for multiple clinical characteristics. Results 123 men (28%) were obese and 149 men (34%) had cancer. Median PSA and age were 5.7 ng/ml and 63.9 years. Obese men had significantly lower PSA concentrations (p=0.02) and larger prostate volumes (p=0.04). Obesity was not significantly related to age (p=0.19) or race (p=0.37). On univariate analysis, obesity was not associated with prostate cancer risk (OR 1.13, 95% CI 0.73–1.75, p=0.58). However, after adjusting for multiple clinical characteristics, obesity was associated with significantly increased prostate cancer risk (OR 1.98, 95% CI 1.17–3.32, p=0.01). After multivariable adjustment, there was no significant association between obesity and high-grade disease (p=0.18). Conclusions Without adjustment for clinical characteristics, obesity was not significantly associated with prostate cancer risk in this equal access clinic-based population. However, after adjusting for the lower PSA levels and the larger prostate size, obesity was associated with a 98% increased prostate cancer risk. These findings support the fact current prostate cancer screening practices may be biased against obese men.

Although no difference was found in complications or conversion rates for either right or left laparoscopic adrenalectomy, the authors report that lower blood loss and decreased operative time were noted with laparoscopic right adrenalectomy.

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