alexa SCREENING FOR CARCINOMA OF THE PROSTATE IN VOLUNTEERS
Surgery

Surgery

Medical & Surgical Urology

Author(s): Martins ACP

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Objectives: To study the incidence of carcinoma of the prostate in a community population and to evaluate parameters such as prostatic specific antigen (PSA) and digital rectal examination (DRE). Material and Methods: Prostate carcinoma first round screening was planned for community men between 40 and 70 years old. One thousand and seventy-nine volunteers were evaluated by DRE and PSA. Two hundred and thirty-five volunteers with PSA greater than 4.0 ng/ml, positive DRE or both were refereed to prostrate biopsy in sextant guided by transrectal ultrasound. Results: Of 136 (57.6%) men that agreed with the biopsy 27 (2.5%) had tumor and 10 (0.9%) had isolated prostatic intraepithelial neoplasia (PIN). No men under 50 years had cancer but in 2 of them, PIN was detected. The sensitivity, specificity and positive predictive value for total PSA and DRE were respectively: 81.4%, 92.7% and 24.1%, and 74.0%, 94.4% and 27.4%. Clinical staging showed disease confined to the gland in 92.5% of patients. Thirteen of these patients were submitted to radical prostatectomy, which revealed that 61.5% of them had tumor stage lower than pT3. Conclusions: The incidence of prostate cancer detected in this first round screening program is within the range previously reported. The PSA cut-off at 4.0 ng/ml for this community showed sensitivity, specificity and predictive positive values within the range published by many centers

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This article was published in Clinical Urology and referenced in Medical & Surgical Urology

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