Use of a BMI-independent biomarker-based prostate cancer risk score to identify and triage individuals at risk of prostate disease

TL;DR

A new BMI-independent prostate cancer risk score could improve cancer detection in overweight men where traditional tests are less reliable.

Contribution

A novel biomarker-based risk score that is not affected by BMI was developed and shown to outperform tPSA in certain populations.

Findings

90.5% of the cohort had low prostate cancer risk based on the new PCRS.

67.8% of men with elevated PCRS had normal tPSA levels.

BMI had a negative correlation with tPSA but not with PCRS.

Abstract

Prostate cancer (PCa) is the second most common cause of cancer related deaths in men in the UK. A national screening programme for PCa does not exist due to the unsuitability of the total prostate specific antigen (tPSA) test which is not specific for PCa and has a high false positive rate. Serum tPSA was measured in n = 25,356 male Randox Health clients. A biomarker-based (tPSA, EGF, MCP-1, IL-8) prostate cancer risk score (PCRS) was then applied to a retrospective cohort (n = 1,142/25,356) of individuals to assess PCa risk. A comparative analysis between tPSA and PCRS indicated that 90.5% of the cohort were assigned low risk of PCa. Of those with an elevated PCRS, 67.8% (78/115) had a normal tPSA value based on tPSA age-adjusted cut-offs. In addition, we observed a significant negative correlation between increasing body mass index (BMI) in men with high BMI (≥ 30) and tPSA levels. No correlation was observed between BMI and PCRS. The tPSA test is potentially unsuitable for use in males with BMI ≥ 30. Use of PCRS could provide more accurate PCa risk stratification for males with BMI ≥ 30. Future assessment of the clinical utility of PCRS is warranted.

The online version contains supplementary material available at 10.1038/s41598-025-13036-w.

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