Prostate Cancer Screening in Brazil: a single center experience in the public health system
Int. braz. j. urol
;
47(3): 558-565, May-June 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1154500
ABSTRACT
ABSTRACT Purpose:
Incidence and mortality of prostate cancer (PCa) are still increasing in developing countries. Limited access to the health system or more aggressive disease are potential reasons for this. Ethnic and social differences in developed countries seem to make inappropriate to extrapolate data from other centers. We aim to report the epidemiological profile of a PSA-screened population from a cancer center in Brazil. Materials andMethods:
We retrospectively selected 9.692 men enrolled in a PCa prevention program, comprising total PSA level and digital rectal examination at the first appointment, associated with complementary tests when necessary. Men aged over 40 years-old were included after shared decision-making process. Prostate biopsy (TRUS) was performed when clinically suspected for PCa. After the diagnosis, patients underwent appropriate treatment.Results:
TRUS was performed in 5.5% of men and PCa incidence was 2.6%. Overall ratio between number of patients who needed to be screened in order to diagnose one cancer was 38.9 patients, with 2.1 biopsies performed to diagnose a cancer. Positive predictive value (PPV) of TRUS biopsy in this strategy was 47.2%, varying from 38.5% (<50 years-old) to 60% (>80 years-old). We evidenced 70 patients (27.9%) classified as low risk tumors, 74 (29.5%) as intermediate risk, and 107 (42.6%) as high-risk disease.Conclusions:
PSA-screening remains controversial in literature. In front of a huge miscegenated people and considering the big proportion of high-risk PCa, even in young men diagnosed with the disease, it is imperative to inform patients and health providers about these data particularities in Brazil.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Prostatic Neoplasms
/
Prostate-Specific Antigen
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adult
/
Aged
/
Aged80
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
AC Camargo Cancer Center/BR
/
Hospital Beneficência Portuguesa de São Paulo/BR
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