Screening For Cancer Prostate:

Mostafa Mahmoud Mostafa

The current study was conducted to evaluate the prevalence ofprostate cancer in a localized community in Qualubia governorate, and todiscover the value and statistical pattern of the diagnostic tools that usedin its early detection.A cross-sectional .short-term prostate cancers screening study wasapplied on 1174 men aged 50 years and older, and all of them wereevaluated by DRE and PSA.Abnormalities in DRE, elevated PSA ~ 4 ng/ml or both wereconsidered positive results. There were 153 men considered positive, 63men of them had PSA ::: 4 ng/ml, 66 men of them had abnormal DREand 24 men of them had both PSA elevation g 4 ng/ml and abnormalDRE.The TRUS and TRUS guided sextant biopsy were applied to the1’53 men that showed positive screening test resultsBy TRUS examination there was no lesion in 84 men, 44 casesshowed hypoechoic lesion, 18 cases showed isoechoic lesion, and 7 casesshowed hyperechoic lesion.There was positive’ biopsy results (prostate cancer) in 23 casesfrom 153 cases who underwent TRUS guided biopsy.The detection rate was 1.7%. when PSA cutoff 4 ng/ml isconsidered the only screenmg test and it was 1.1% when ORE isconsidered as a screening test alone, and by using both test the detectionrate generally was 1.9%, so the use of both tests together is essential toavoid missing any cases.The detection rate in the age group from 50 to less than 60 years was0.8%, in the age group from’ 60 to less than 70 years it was 2.1% andfrom 70 years and more it was 6.6%.The sensitivity of the screening tests in prostate cancer detectionwas 86.9% fer PSA and 60.8% for ORE, and specificity was 48.5% forPSA and 41.5% for ORE, and the sensitivity of TRUS in detection oflesions suspecting malignancy was 62.5 % and specificity was 58.5%.The pathological diagnosis of the 23 cases of prostate cancer wasadenocarcinoma, with Gleason sum 5 in ten cases, Gleason sum .6 inseven cases, Gleason sum 7 in five cases, and Gleason sum 8 in one case.The use of ORE and PSA in prostate cancer screening is an effectivemethods in diagnosing prostate cancer especially the early formsAs the incidence of prostate cancer in Egypt is expected to beincreased due to the more availability of the diagnostic modalities and therelative increase in the male life expectancy ,so it the time now torecommend for prostate cancer screening to discover the disease in earlierstage make it more amenable for effective treatment.