Accuracy of digital rectal examination to diagnose prostate cancer confirmed by needle biopsy reports: A 3­year hospital-based study

Background: Digital rectal examination (DRE) is an indispensable tool for provisional diagnosis of prostate diseases. When abnormal prostate examination findings are elicited, a diagnosis of prostate cancer (Pca) is usually entertained and further tests to confirm or rule out the presence of Pca demands histological examination of biopsied tissue. A combination of DRE findings and serum PSA increases the predictive value for Pca diagnosis. In this study, we evaluated the degree of accuracy of DRE to diagnose Pca confirmed by histology reports of biopsy specimens.Materials and Methods: Two hundred and six (206) patients were studied over a period of three years. Information retrieved from their case notes were entered into a well-structured protocol for management of prostatic diseases. Analysis of variables collated was performed with the statistical package for the social sciences (SPSS) version 20.0. Frequency table was used to analyze categorical variables while descriptive statistics was used for continuous variables. Level of significance was set at P<.05.Results: 206 patients were studied with mean age of 68.23±8.71 years ranging from 48 to 91 years. Men in the Pca group were older than those in the BPH group. Abnormal DRE was associated with high grade tumours, and high level of aggressive tumour characteristics by WHO grade group standard.Conclusion: DRE has a high level of accuracy in predicting a diagnosis of Pca which was confirmed by histology reports especially in prostates with abnormal findings

Aspects paracliniques du cancer de la prostate à Cotonou : à propos de 109 cas

But : Explorer les aspects paracliniques du cancer de la prostate à Cotonou et plus spécifiquement les aspects épidémiologiques, biologiques, radiologiques et anatomo-pathologiques. Patients et méthodes : Il s'agissait d'une étude rétrospective à visée descriptive sur une durée de huit ans, colligeant tous les cas de cancer de la prostate diagnostiqués au service d'Urologie-Andrologie du CNHU HKM de Cotonou.Résultats : 109 cas ont été colligés au total. L'incidence du cancer de la prostate sur les 8 ans était de 4,7%. Le taux moyen de PSA était de 830,2 ng/ml. Le seul type histologique retrouvé après examen histologique des pièces de biopsie était l'adénocarcinome. Dans 28% des cas le score de Gleason était 6. L'imagerie d'extension la plus réalisée était la radiographie conventionnelle (62,4%). L'atteinte à distance la plus fréquente était celle osseuse (52,9%). La classification TNM de la majorité des patients étaient T2cNxMx (25,6%) Conclusion : Le cancer de la prostate est une pathologie du sujet âgé de plus de 50 ans souvent vu tardivement dans notre milieu. Son diagnostic paraclinique onéreux sous nos cieux rend difficile la réalisation du bilan d'extension et limite les indications de chirurgie radicale

Aspects paracliniques du cancer de la prostate à Cotonou : à propos de 109 cas

But : Explorer les aspects paracliniques du cancer de la prostate à Cotonou et plus spécifiquement les aspects épidémiologiques, biologiques, radiologiques et anatomo-pathologiques. Patients et méthodes : Il s'agissait d'une étude rétrospective à visée descriptive sur une durée de huit ans, colligeant tous les cas de cancer de la prostate diagnostiqués au service d'UrologieAndrologie du CNHU HKM de Cotonou. Résultats : 109 cas ont été colligés au total. L'incidence du cancer de la prostate sur les 8 ans était de 4,7%. Le taux moyen de PSA était de 830,2 ng/ml. Le seul type histologique retrouvé après examen histologique des pièces de biopsie était l'adénocarcinome. Dans 28% des cas le score de Gleason était 6. L'imagerie d'extension la plus réalisée était la radiographie conventionnelle (62,4%).L'atteinte à distance la plus fréquente était celle osseuse (52,9%). La classification TNM de la majorité des patients étaient T2cNxMx (25,6%) Conclusion : Le cancer de la prostate est une pathologie du sujet âgé de plus de 50 ans souvent vu tardivement dans notre milieu. Son diagnostic paraclinique onéreux sous nos cieux rend difficile la réalisation du bilan d'extension et limite les indications de chirurgie radicale

Investigating racial differences in clinical and pathological features of prostate cancer in South African men

Introduction: Men with West African ancestry living in Europe and North America are at higher risk of being diagnosed with prostate cancer, are diagnosed at a younger age, and have more severe disease characteristics. Published reports present a conflicting picture of the disease in sub-Saharan Africa. We aimed to study the clinical and pathological features of men undergoing prostate biopsy from different racial backgrounds in South Africa in an attempt to characterise the disease locally. Our hypothesis was that black African men presenting to our service had more severe disease characteristics than other patients. Methods: All patients who underwent a prostate biopsy at Groote Schuur Hospital, Cape Town from July 2008 to July 2014 were studied. For each patient, data were collected on age, self-assigned race, presenting symptoms, prostate-specific antigen (PSA) level, prostate volume, and histological diagnosis. Results: A total of 1016 patients were studied. 162 (15.9%) were black and 854 (84.1%) were coloured (mixed ancestry), white, or Asian. Black patients were compared as a group to the coloured, white and Asian patients. The black patients in the series had higher PSA values (mean 167.8 vs 47.7, median 16.4 vs 10.9, p < 0.001), were more likely to be diagnosed with cancer (57.4% vs 44.5%, p = 0.003), were more likely to present with locally advanced cancer (T3/4 16.1% vs 8.9%, p = 0.028), and were more likely to have high grade disease (Gleason ≥ 8 45.2% vs 30.5%, p = 0.011). There was no difference in age, presenting symptoms, or prostate volume. Conclusion: The black men diagnosed with prostate cancer at Groote Schuur Hospital had significantly worse clinical and pathological characteristics than the non-black men. Interpreting these differences as representative of a more common or aggressive disease among black men is not possible due to study limitations

Knowledge of Prostate Cancer Screening among Native African Urban Population in Nigeria

Background: Prostate cancer is the must commonlydiagnosed cancer in men worldwide and ranked second as the cause of death in cancer-related diseases. Objective: To evaluate the awareness and attitude of the populace to screening for cancer of the prostate. Methods: It is a cross-sectional study involving 156 respondents. A structured questionnaire detailing the biodata, the knowledge of cancer of prostate, the practice of screening by prostate specific antigen (PSA) estimation and the readiness to undergo screening by the respondent was used to obtain the set-out objectives. Results: A total of 156 respondents completed the questionnaire and forms the basis of further analysis. The mean age of the respondents is 44.15 (±11.9) years. Majority of the respondents were civil servant (51.9%) followed closely by politicians. About 23.1% of them have no formal education while 53.8% have acquired tertiary education. The result shows that 78.8% have never heard any information on cancer of the prostate and only 5.8% had heard about PSA. None of the respondents have ever had PSA test, even once. Eighty four per cent of the respondents are ready to pay for prostate cancer screening test by PSA assay. Conclusion: We conclude that there is remarkable lack of awareness of prostate cancer among the Nigerian native African urban populace. Prostate cancer screening and serum PSA test for screening is globally unknown among them

Is Prostate Cancer more Common and more Aggressive in African Men?

The highest prostate cancer incidence and mortality rates in the world have been reported among Black African-American men (AAM) living in the United States of America. These rates are significantly higher for AAM compared to White (Caucasian) American men (CAM). However; prostate cancer is not the only malignancy which is more common in AAM compared to White American men or women. Although prostate cancer has the highest Black/White mortality ratio; it is not the only malignancy which has a higher mortality in AAM compared to CAM. Numerous reports have shown that AAM present with higher grade and stage tumors; higher serum PSA levels; and that they are less likely to receive definitive or curative treatment and have a worse prognosis compared with CAM. It has been suggested that prostate cancer is not only more common; but also more biologically aggressive in AAM compared with CAM. Hypotheses attempting to explain this include genetic differences; dietary factors; higher testosterone levels or increased androgen receptor activity. However; the majority of reports from the USA indicate that; when controlled for major prognostic factors; the outcome for clinically localized as well as advanced prostate cancer does not depend on race. Several studies have indicated that socio- economic factors; decreased awareness of prostate cancer and limited access or decreased utilization of health care contribute to the poorer outcomes in AAM. Earlier studies have suggested that prostate cancer is relatively rare among indigenous Black men living in Africa. However; cancer incidence data in Africa are likely to underestimate the true rates because of underdiagnosis and underreporting. The frequency distribution of cancers in African countries; as well as more recent data indicate that prostate cancer is not rare among Black men living in Africa and that the incidence is probably similar to that of White men; although not as high as that reported for Black men living outside Africa. It is well documented that African men with prostate cancer present with more advanced disease and that palliative rather than curative treatment is used in the majority of patients. There are no reliable age-adjusted prostate cancer mortality rates available for African countries. However; there is as yet no evidence that prostate cancer in Black men living inside Africa is biologically more aggressive than in other populations

Profil clinique du cancer de la prostate au Senegal

Objectives: To describe the clinical features of prostate cancer in Senegal. Materials and Methods: We underwent a descriptive and retrospective study including 121 patients managed for prostate cancer in two hospitals of Dakar between 1997 and 2002. The histological diagnosis was assessed on prostate biopsy or after transurethral resection of the prostate or prostatectomy. We studied: the age of the patients; the PSA level; the stage of the tumor using the TNM staging of 1997; and the circumstances of diagnosis. Results: The mean age was 69 years (52-88); the mean PSA was 72;2 ng /ml (6-578;9). The localized tumors that represented 43;8of the cases were mainly T2 (42;1); while the advanced (T3-T4) tumors represented 41;3of the cases. Metastases were found in 15of cases; and in 78of the cases the metastases could not be assessed. The circumstances of diagnosis were dominated by prostate or cancer-related symptoms which represented 49;6of the cases. The association between symptoms and high PSA was present in 16;5of cases. Conclusion: This study shows an elevated age of our patients correlated with a high PSA level; an advanced tumor stage; an important rate of metastases and the presence of symptoms. Screening is needed for a better management of prostate cancer in Senegal

Clinical prognostic factors in patients with advanced stage prostate cancer

Objectives: To determine the prognostic factors that could predict patient outcome in patients with advanced stage prostate cancer. Patients and Methods: In this study we retrospectively evaluated the medical record data of 222 patients with advanced stage prostate cancer treated by hormonal therapy (either castration or total androgen blockade (TAB)). All pre- and post- treatment data records were evaluated with respect to patient age; prostate and tumor size; tumor grade; stage; PSA; alkaline and acid phosphatase and the number of bone lesions. The response to the hormonal treatment was evaluated either early (12 months after treatment) or late (over all follow-up visits until the last visit or death). Descriptive statistics; student T test; multivariate and Kaplan Meier's curve were used for data analysis. Results: Within 12 months of treatment 70of the cases showed an improvement with a significant decrease of their pre-treatment values after hormonal therapy. Patient age; tumor stage; the number of bone lesions; serum alkaline and acid phosphatase levels in the pre-treatment data were significantly independent predictors of the overall survival outcome (p= 0.0015; 0.002; 0.001; 0.0002 and 0.028; respectively); while the pre-treatment PSA serum level; tumor grade and the type of hormonal treatment used (either castration or TAB) were no predictors of patient outcome (p= 0.18; 0.82 and 0.47; respectively). Importantly; the PSA serum level and the number of bone lesions in the first 12 months of patient follow-up were significant predictors of the overall disease survival status (p=0.001 and 0.028; respectively). The mean follow-up period of alive cases was 39.42 months ranging from 6 - 171 months. Of the 222 cases 110 (51.6) had overall disease progression during a mean of 59.4 months; while mortality was reported in 118 cases (53.2) in the course of a mean of 59.9 months. Conclusion: The pre-treatment patient age; tumor stage; serum alkaline and acid phosphatase; as well as the post-treatment PSA level and the number of bone lesions were significant independent predictors of the overall patient outcome in patients with advanced stage prostate cancer. However; a survival analysis in relation to the treatment type did not reveal a statistically significant difference between the outcomes of castration and TAB