Today men with prostate cancer have larger prostates

Objectives. To examine the relationship between prostate size and the metho d of cancer detection in men with organ-confined prostate cancer, and compa re prostate size in men with and without cancer. Methods. Prostate volume was evaluated in 720 men who had undergone radical prostatectomy for Stage Tie or Stage T2 cancer. Men with Stage T2 cancer w ere divided into those treated before 1989 (when widespread prostate-specif ic antigen [PSA] testing began), or not. Gland volume was also examined in 265 men participating in the Baltimore Longitudinal Study of Aging who had no clinical evidence of cancer. Volumes were compared using linear regressi on to allow for age. Results. Prostate volume in men with Stage Tie cancer was statistically sig nificantly larger than in men with Stage T2 cancer diagnosed in the pre-PSA era after adjusting for age (P = 0.0001), and statistically significantly larger than in men without cancer above age 47 years based on 95% confidenc e intervals. Prostate volumes in men with Stage T2 cancer diagnosed in the pre-PSA era and in men without cancer were not statistically significantly different. Conclusions. Prostate volume in men with PSA-detected, organ-confined cance r is larger than in men with palpable organ-confined cancer diagnosed in ei ther the pre-PSA era or PSA era. These discrepancies may reflect a diagnost ic bias due to the effect of benign prostatic hyperplasia on serum PSA that results in the selection of men with larger prostates for biopsy. UROLOGY 56: 839-842, 2000. (C) 2000, Elsevier Science Inc.