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Insulin-Like Growth Factor I Is Not a Useful Marker of Prostate Cancer in Men with Elevated Levels of Prostate-Specific Antigen¹

Departments of Clinical Chemistry (P.F., W.-M.Z., U.-H.S.), Obstetrics and Gynecology (H.K., M.S.), and Urology (S.R.), Helsinki University Central Hospital, FIN-00029 Helsinki, Finland; STUK–Radiation and Nuclear Safety Authority (A.A.), FIN-00881 Helsinki, Finland; Finnish Cancer Registry (A.A., L.M., M.H.), FIN-00170 Helsinki, Finland; and School of Public Health, University of Tampere (M.H.), and Division of Urology, Tampere University Hospital (T.T.), FIN-33521 Tampere, Finland

Address all correspondence and requests for reprints to: Patrik Finne, M.D., Department of Clinical Chemistry, Helsinki University Central Hospital, P.O. Box 140, FIN-00029 Helsinki, Finland. E-mail: patrik.finne{at}hus.fi

High serum levels of insulin-like growth factor I (IGF-I) and low levels of IGF-binding protein-3 (IGFBP-3) have been shown to correlate with increased prostate cancer risk. To evaluate this, IGF-I, IGFBP-3, and prostate-specific antigen (PSA) were measured in serum from 665 consecutive men (179 with prostate cancer), aged 55–67 yr, with elevated serum prostate-specific antigen (PSA; 4 µg/L) in a screening trial. Men in the highest quartile of IGF-I levels had an odds ratio (OR) for prostate cancer of 0.50 [95% confidence interval (CI) 0.26–0.97] when adjusting for serum IGFBP-3. IGFBP-3 itself was not significantly associated with prostate cancer risk (OR, 1.24; 95% CI, 0.68–2.24). Prostate volume was larger in men without than in those with prostate cancer (P < 0.001), and after adjustment for prostate volume, the negative association between serum IGF-I and prostate cancer risk was no longer significant (OR, 0.57; 95% CI, 0.28–1.16). In screen-positive men with elevated serum PSA, serum IGF-I is not a useful diagnostic test for prostate cancer, but it may be associated with benign prostatic hyperplasia and enlargement.

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