rationale for prostate cancer detection in a developing country: comparison of screening and case finding

ABSTRACT

Objective: This study was conducted to compare the results of community based screening program for prostate cancer with case finding among urologic patients. Patients and Methods: Two programs for prostate cancer detection were conducted based on PSA assay [cutoff value 4ng/ml] and DRE for men aged 50 to 75 years. The first one included 833 urologic patients [group 1] and the second included 882 men who responded to a campaign for early detection of prostatic diseases [group 2]. Diagnosis of prostatic adenocarcinoma depends on ultrasound guided six-core prostatic biopsies. Results: In group 1, 154 patients were biopsied [147 due to high PSA +/- suspicious DRE and 7 due to suspicious DRE alone]. Prostate cancer was diagnosed in 36 patients [4.3%]. Organ confined cancer was detected in 41.7% of them [15 patients]. In group 2, 75 men were biopsied [69 for high PSA +/- suspicious DRE and 6 for suspicious DRE alone].The cancer detection rate was 2.2% [19 patients] and the rate of organ confined disease was 37.87 [7 patients]. There was no significant statistical difference between both groups regarding cancer detection rates and the percent of organ confined tumors. Conclusion: The results of this study may present a rationale for application of prostate cancer detection program in developing countries to urologic patients