Effect of Statins on Serum Prostate-specific Antigen Levels

Objectives: The use of statins, which are cholesterol-lowering drugs, has increased significantly during the last decade. In this study, we investigate the effect of statins on serum prostate-specific antigen (PSA) levels in men participating in a prostate cancer screening event.

Methods: A cohort of 4903 men who participated in Prostate Cancer Awareness Week in the years 2007 or 2008 were enrolled in this study from multiple clinical institutions. Within this cohort 1379 men (28.2%) were on a statin medication. Serum PSA, total testosterone, and total cholesterol were compared between the cohort of men using statins and the cohort of men who did not indicate current statin use. In multivariate regression analysis we controlled for age, body mass index (BMI), and race.

Results: The mean age of the population was 60.7 years. Serum testosterone levels in patients on statin medication were significantly lower than in patients not on statins (P < .001). Mean total cholesterol levels were similar between the 2 groups (P = .229). Mean serum PSA level was 1.56 ng/mL in patients on statin medication and 1.48 ng/mL in patients not on statin (P = .120). After adjusting for significant covariates (age, BMI, and race), statin use was shown to have a significant association with lower mean PSA (P = .008) and lower mean testosterone (P < .001) and similar total cholesterol (P = .083).

Conclusions: Although use of statins may lower serum PSA levels, its clinical impact is limited. It may not be necessary to determine a different PSA cutoff level for patients on statin medication.