Urology

Urine pH: Potential Biomarker for Prostate Cancer?

Acidic urine pH, or pH under 5.0, could play a role in predicting prostate cancer, according to new findings published in Urologia.1

Researchers arrived at their conclusion after retrospectively assessing patients who underwent 12-core prostate biopsy due to elevated prostate-specific antigen levels and abnormal findings from a digital rectal examination. After reviewing patients’ pathology, those with a diagnosis of prostate cancer were placed in group 1 (n = 119), and those with benign prostatic hyperplasia were placed in group 2 (n = 99).

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Ultimately, mean urine pH was found to be 5.1 in group 1 compared with 5.5 in group 2. Using receiver operating characteristic curve analysis, the researchers determined the cut-off value for urine pH to be 5.2, with a sensitivity of 42%, specificity of 79%, and area under the curve of 0.61. More studies may be needed to determine whether urine pH could eventually play a role in predicting prostate cancer.

Risk and Screening Recommendations

Second only to non-melanoma skin cancer, prostate cancer is the most common cancer among US men.2 Prostate cancer will occur in approximately 13% of men at some point in their lives, and 2% to 3% of cases will result in mortality.3 Factors associated with increased risk of prostate cancer include family history and African American race.3

Prostate cancer screening recommendations issued by the US Preventive Services Task Force in 2018 include:4

  • The decision for men aged 55 to 69 years to receive PSA-based screening for prostate cancer should be an individual one.
    • Clinicians and patients should discuss the potential benefits and harms of screening.
    • Clinicians should consider each patients’ family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs when weighing the benefits and harms of screening.
  • Men who do not express a preference for screening should not be screened (C recommendation).
  • PSA-based screening for prostate cancer is not recommended for men aged 70 years and older (D recommendation).


—Christina Vogt

References:

1. Ceylan C, Doluoglu OG, Yahşi S. A different perspective: Can urine pH be important in the diagnosis of prostate cancer? [Published online July 31, 2019]. Urologia. doi:10.1177/0391560319865724.

2. Prostate cancer statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/prostate/statistics/index.htm. Page last reviewed May 28, 2019. Accessed August 7, 2019.

3. Who is at risk for prostate cancer? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/prostate/basic_info/risk_factors.htm. Page last reviewed July 31, 2019. Accessed August 7, 2019.

4. US Preventive Services Task Force. Screening for prostate cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(18):1901-1913. doi:10.1001/jama.2018.3710.