Assessment of Screening for Prostatic Cancer in Men with Prostatism more than 50 years old

Kim, Kyung An; Lee, Sang Kon

Abstract

Screening for prostatic cancer remains controversial because a decrease in the mortality rate is not demonstrated in screened populations. During a 2 year period, 172 men with prostatism more than 50 years old, were examined for prostatic cancer prospectively. A prostatic biopsy was performed on 77 men and 13 malignant tumor were detected, of which 85 per cent were clinically localized. Sensitivity of digital rectal examination, serum PSA, and transrectal ultrasonography for detection of prostatic cancer was 46.2%, 76.9%, and 53.8% respectively. A combination of abnormal ultrasonographic findings, an elevated PSA value, and abnormal findings on rectal examination carried a positive predictive value of 62.5%. These results suggest that screening examination may benefit for early detection of prostatic cancer in men with Prostatism more than 50 years old. Screening program should include digital rectal examination, serum PSA initially. Transrectal ultrasonography is reserved for cases with abnormal finding on rectal examination or elevated PSA value.