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. 2016 Jun 20:5:112.
doi: 10.4103/2277-9175.184298. eCollection 2016.

Evaluation of prostatic cancer prevalence in patients with prostatic-specific antigen between 4 and 10 and normal digital rectal examination

Farhad Tadayon  1 , Hamid Reza Arezegar  1 , Mohammad Hatef Khorrami  1 , Rasoul Hashemi Juzdani  1 , Amir Abbas Shahdoost  1 , Mehdi Mellat  1
Affiliations

Evaluation of prostatic cancer prevalence in patients with prostatic-specific antigen between 4 and 10 and normal digital rectal examination

Farhad Tadayon et al. Adv Biomed Res. .

Abstract

Background: Prostate cancer is one of the most common male cancers. The prevalence of prostate cancer is different due to genetic and environmental factors. Diagnosis of prostate cancer is by biopsy due to prostate-specific antigen (PSA) and Digital Rectal Examination (DRE). Controversy about decision making for prostate biopsy in PSA between 4 and 10 and normal DRE, is one of the problems in this time. In this study we evaluated the prevalence of prostate cancer in males with PSA between 4 and 10 and normal DRE. We also evaluated the PSA density and percent of free PSA in patients with prostate cancer.

Materials and methods: A total of 121 males with PSA between 4 and 10 and normal DRE, were evaluated. Then, transrectal ultrasonography (TRUS) andprostate biopsy from 12 points of peripheral zone, was done. These data were analyzed by Chi-square, t-test and ANOVA and Roc curve.

Results: In this study, the prevalence of prostate cancer in PSA between 4 and 10 and normal DRE, was evaluated, 29.8%. With use of Roc curve, PSA density cutoff point was calculated 0.12 and percent of free PSA cutoff point, was calculated, 18%.

Conclusion: In males with PSA between 4 and 10 and normal DRE, PSA density smaller than 0.12-0.15, and percent of free PSA greater than 18%, the prevalence of prostate cancer is very few and we can safely ignore the TRUS and prostate biopsy in these males and eliminate its costs and side effects.

Keywords: Benign prostatic hyperplasia; digital rectal examination; percentage of free prostate-specific antigen; prostate cancer; prostate-specific antigen; prostate-specific antigen density.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Prevalence of prostate cancer in different ages
Figure 2
Figure 2
Prevalence of prostate cancer in different prostate-specific antigens (PSAs)
Figure 3
Figure 3
ROC curve of free PSA percent
Figure 4
Figure 4
ROC curve of PSA density
See this image and copyright information in PMC

References

    1. Ballentine H. Diagnosis and staging of prostate cancer. In: Allaf ME, Carter HB, editors. Textbook of urology. Wein-Campbell-Walsh Urology. Philadelphia: Saunders Company; 2007. p. 291231.
    1. Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE, et al. Combination of prostate-specific antigen, clinical stage, and gleason score to predict pathological stage of localized prostate cancer. JAMA. 1997;277:1445–51. - PubMed
    1. Catalona WJ. PSA testing: Who, what, and when. School of Medicine in Chicago. 2006. [Last accessed on 2006 Jan]. Available from: http://www.ajaxpro.info .
    1. Luboldt HJ, Swoboda A, Börgermann C, Fornara P, Rübben H. Early Detection Project Group of the German Society of Urology. Clinical usefulness of free PSA in early detection of prostate cancer. Onkologie. 2001;24:33–7. - PubMed
    1. Klingler HC, Woo H, Rosario D, Cutinha PE, Anderson J, Ward AM, et al. The value of prostate specific antigen (PSA) density and free: Total PSA ratio in selecting patients with a normal digital rectal examination and intermediate total PSA levels for further investigation. Br J Urol. 1998;82:393–7. - PubMed