Medical Oncology

, Volume 28, Issue 1, pp 357–364

Clinical and pathological characteristics of screen-detected versus clinically diagnosed prostate cancer in Nanjing, China

  • LiXin Hua
  • Di Qiao
  • Bin Xu
  • NingHan Feng
  • Gong Cheng
  • JieXiu Zhang
  • NingHong Song
  • Wei Zhang
  • Jie Yang
  • JianGang Chen
  • YuanGeng Sui
  • HongFei Wu
Original Paper

Abstract

Previous studies have suggested that implementation of PSA screening in China is of crucial importance. This study compared clinical and pathological characteristics of screen-detected and clinically diagnosed prostate cancers and evaluated the effectiveness of PSA screening for early detection of prostate cancer in Nanjing. Between July 2004 and December 2005, 8,562 men aged ≥50 years were included for PSA screening. Participants with serum PSA ≥4.0 ng/ml were recommended for transrectal ultrasonography (TRUS)-guided prostate needle biopsy (TRNB). During the same period, 82 consecutive clinically diagnosed prostate cancers were included as controls. The clinical and pathological features of the screened versus clinically diagnosed cancers were evaluated. A total of 719 (8.4%) of screened men had PSA levels ≥4.0 ng/ml. Biopsy was performed in 295 men, and 58 prostate cancers were detected. The biopsy rate, positive predictive value (PPV), and detection rate were 41.0, 19.7, and 0.68%, respectively. More screened patients were found with PSA levels <20 ng/ml (55.2 vs. 22.4%, P < 0.001), Gleason scores <7 (60.3 vs. 34.1%, P = 0.002), organ-confined tumors (87.9 vs. 26.8%, P < 0.001), and opportunities for radical prostatectomy (50.0 vs. 18.3%, P < 0.001) than that in clinically diagnosed patients. PSA screening is effective for early detection of prostate cancer in Chinese elderly men. Favorable PSA levels, Gleason scores, clinical stages, and chances for radical prostatectomy are associated with PSA screening. Further studies are needed to evaluate the effect of screening on treatment outcomes and mortality of prostate cancer in Chinese.

Keywords

Prostate cancer Screening China Prostate-specific antigen 

Abbreviations

AJCC

American Joint Committee on Cancer

CT

Computed tomography

DRE

Digital rectal examination

ERSPC

European randomized study of screening for prostate cancer

LUTS

Lower urinary tract symptoms

MRI

Magnetic resonance imaging

PLCO

Prostate, lung, colorectal and ovarian

PPV

Positive predictive value

PSA

Prostate-specific antigen

SD

Standard deviation

TRNB

Transrectal ultrasonography-guided prostate needle biopsy

TRUS

Transrectal ultrasonography

UICC

Union Internationale Contre le Cancer

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • LiXin Hua
    • 1
  • Di Qiao
    • 2
  • Bin Xu
    • 1
  • NingHan Feng
    • 1
  • Gong Cheng
    • 1
  • JieXiu Zhang
    • 1
  • NingHong Song
    • 1
  • Wei Zhang
    • 1
  • Jie Yang
    • 1
  • JianGang Chen
    • 1
  • YuanGeng Sui
    • 1
  • HongFei Wu
    • 1
  1. 1.Department of UrologyFirst Affiliated Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Department of UrologyJiangsu Provincial Research Institute of GeriatricsNanjingChina

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