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Japanese Journal of Clinical Oncology Advance Access published online on May 30, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl032
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© 2006 Foundation for Promotion of Cancer Research
Received February 14, 2006
Accepted March 22, 2006

Original Article

Detection of Prostate Cancer at Low and Intermediate Serum Prostate-Specific Antigen Levels in a Country with a Low Incidence of Prostate Cancer

Sang Eun Lee 1, Seok-Soo Byun 1, Hyoung Keun Park 2, Hong Bang Shim 3, and Ja Hyeon Ku 3 *

1 Department of Urology, Seoul National University College of Medicine, Seoul, Korea
2 Department of Urology, DongGuk University International Hospital, Goyang, Korea
3 Department of Urology, Seoul Veterans Hospital, Seoul, Korea

* To whom correspondence should be addressed.
Ja Hyeon Ku, E-mail: randyku{at}hanmail.net


  Abstract

Background: The objective of this study was to evaluate the cancer detection rate and the pathologic findings of biopsy in men at low and intermediate prostate-specific antigen (PSA) levels in an Asian population.

Methods: Patients between 40 and 79 years were entered into a study and 755 patients with serum PSA level of 2.0-10.0 ng/ml underwent trus-guided systematic biopsy. Patients were divided to low (PSA 2.0-4.0 ng/ml, n = 144) and intermediate (PSA 4.1-10.0 ng/ml, n = 611) PSA groups.

Results: Patients in the low PSA group had significantly smaller prostates (P = 0.003) and lower PSA density (P < 0.001). The rate of cancer detection was 16.7% (24 of 144) in the low PSA group and 23.7% (145 of 611) in the intermediate PSA group (P = 0.067). In men with normal digital rectal examination (DRE), prostate cancer was diagnosed in 14 (13.3%) of the 105 men in the low PSA group and 99 (19.5%) of the 508 men in the intermediate PSA group (P = 0.139). In all patients and patients with normal DRE, no statistically significant differences were found in the pathologic findings of biopsy between the two groups.

Conclusions: Our findings provide a rationale to recommend prostate biopsy at lower PSA threshold in this population. At present, however, it is not clear that men who are treated when their cancers are detected at lower PSA levels have better outcomes than those who are treated when the PSA is higher than 4.0 ng/ml.

Keywords: prostate-specific antigen; prostate neoplasms; prostate cancer; Asian.
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