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Prostate Cancer Screening in Brazil: a single center experience in the public health system
Oliveira, Renato Almeida Rosa de; Guimarães, Gustavo Cardoso; Mourão, Thiago Camelo; Favaretto, Ricardo de Lima; Santana, Thiago Borges Marques; Lopes, Ademar; Zequi, Stenio de Cassio.
  • Oliveira, Renato Almeida Rosa de; Hospital Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Guimarães, Gustavo Cardoso; Hospital Beneficência Portuguesa de São Paulo. São Paulo. BR
  • Mourão, Thiago Camelo; Hospital Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Favaretto, Ricardo de Lima; Hospital Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Santana, Thiago Borges Marques; Hospital Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Lopes, Ademar; AC Camargo Cancer Center. São Paulo. BR
  • Zequi, Stenio de Cassio; AC Camargo Cancer Center. Divisão de Urologia. São Paulo. BR
Int. braz. j. urol ; 47(3): 558-565, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154500
Responsible library: BR1.1
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 and

Methods:

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.
Subject(s)


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 / 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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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 / 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