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Health See other Health Articles Title: Does Bicycling Affect PSA? 'm Dr Gerald Chodak for Medscape. Today I want to talk about the possible effect of cycling on men who are going to get a serum prostate-specific antigen (PSA) level. Jiandani and coworkers[1] conducted a literature review to find articles related to this topic. Eight studies met their inclusion criteria, of which six formed the basis of a meta-analysis. Unfortunately, there were only about 912 patients included in their overall analysis. Of the six studies in the meta-analysis, [one] found PSA increases as a result of cycling,[2] whereas [five] studies did not observe a significant difference.[3-7] The problem with the meta-analysis is that not only are the series quite small, but there were also variations in the age of the population and the duration of the cycling, and so one has to be very cautious about how to interpret the results, as was done by the authors; they did not overreach or overextend their conclusions. They did conclude, however, that there was no clear evidence that cycling did increase PSA. So, where does that leave us with a message for the general public? I think that unless we get a true, randomized controlled trial, we will continue to debate whether there is an effect, as some men do, in fact, have a rise in their PSA as a result of the cycling. We do know that if we take random PSA levels from people, there are fluctuations that occur quite often, and the causes for those fluctuations are not entirely clear. Some people have suggested that even a bowel movement or sexual activity, or even a recent rectal exam, may cause a rise in the PSA. What should we tell our patients at this time? Can we tell them definitively that cycling is a safe thing to do the day before they are going to have their PSA level checked? That doesn't seem to be a good conclusion or good recommendation. I think that for men who are getting routine PSAs to rule out the possibility of prostate cancer, they want to do everything possible to minimize fluctuations that could result in a biopsy and the possible finding of a clinically insignificant cancer. That would mean avoiding a bowel movement, avoiding sexual activity, and even avoiding cycling for about 24 hours prior to their test. It is probably the best thing they can do to ensure a relative stability to their PSA that has been taken either 6 months ago or even a year ago. Editors' Recommendations PSA Screening: New Approach Could Shift Risks/Benefits Higher-Risk Prostate Cancers in US May Have Increased USPSTF: Prostate Cancer Screening Gets a 'D' Post Comment Private Reply Ignore Thread
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