Use of PSA in prostate cancer screening in male physical examination population over 50 years in Beijing / 中华泌尿外科杂志

ABSTRACT

Objective To study the role of using PSA in prostate cancer screening in the male physical examination population over 50yrs in Beijing.Methods From January 2010 to December 2010,in Physical Examination Center of Beijing Hospital and Beijing MeiZhao Health Screening Center,men over 50years with PSA records in the past three years (from 2007 to 2009) were selected.The exclusion criteria included history of prostate cancer,severe diseases of the heart,brain,lung,liver and kidney,and mental or neurological disorders.People who couldn't cooperate with the investigation due to any reasons were excluded as well.The number of recruited cases was 2862.Among the cases,males with PSA over 4 μμg/L received prostate biopsy after singing the informed consent form.The average age was 67.2 ± 9.3 years.Results In the 2862 males,2621 cases (91.5％) had normal PSA levels and 241 cases (8.5％) had abnormal PSA levels.With the age increasing from 50 to 89 years,the proportion of abnormal PSA levels increased significantly from 2.7％ to 10.9％,P ＜ O.001.86 patients (33.2％) received prostate biopsy in the group of abnormal PSA levels; The positive prostate biopsy rate was 41.4％ (39/86).In PSA ＜4 μg/Lgroup,the positive rate was 25.0％ ; in 4 μg/L≤PSA ＜ 10 μg/L group,the positive rate was 29.8％ ; in PSA ≥ 10 μg/L group,the positive rate was 68.9％,P ＜ 0.001.With the PSA level increasing,the proportion of the localized cancer decreased from 100％ to 70％,and the ratio of locally advanced and distant metastatic tumor increased from 0 to 30％ ; the proportion of Gleason≤6 fell from 100％ to 30％,the proportion of Gleason ≥ 8 increased from 0 to 50％.The differences above did not show statistical significance.Conclusions Use of PSA in prostate cancer screening for men over 50 years could increase the detection rate of prostate cancer.