Estimation of Prostatic Cancer Prevalence in Korea: An Epidemiological Survey in Kangseo-Gu, Pusan

Yoon, Jin Han; Jung, Se Il; Kim, Soo Il; Choi, Man Seok; Lee, Seong Ho; Jung, Gyung Woo

Abstract

PURPOSE: The prostate cancer is one of the most prevalent disease in the Western world. Recently, with the increase of old-aged population and the westernized diet, prostate cancer patients have increased in Korea. We have studied the prevalence of prostate cancer in Kangseo-Gu, Pusan. MATERIAL AND METHODS: From September to November 1996, a representative sample of 433 volunteers were chosen randomly and were monitored. Of these, 393 participants were older than 50 years and were not within the urological practice. Screening programs used here are international prostatic symptom score(1-PSS), digital rectal examination(DRE) and serum prostate specific antigen(PSA) with an immunoenzymatic assay(Tandem-E). The transrectal ultrasonography(TRUS) is reserved for the cases with an abnormal finding on the rectal examination or the elevated PSA value. Transrectal biopsy of prostate was recommended in the cases of PSA greater than 4ng/ml, suspicious nodules on DRE or TRUS, or when more than two of these findings were discovered.
RESULTS
The detection rates and the positive predictive values for the DRE were 1.02% and 7.7%, TRUS were 1.27% and 15.2%, and PSA were 1.02% and 16.7% respectively. When the TRUS and PSA tests were combined, the positive predictive value was increased to 33.3% and when all three tests were combined, the predictive value increased further to 57.1%. However, the detection rate did not change with combinations of these tests. When the PSA cut-off value was increased from 4.0ng/ml to 10.0ng/ml, the positive predictive value increased from 11.1% to 33.3%.
CONCLUSIONS
From the above examinations, 5 of the 393 samples had prostate cancer, yielding detection rate of 1.27%. The results of our community-based study suggest that there are about 4,5000 people suffering from the prostate cancer, with the prevalence of 1.27%. This value of prevalence of prostate cancer in Korean population is much lower than the western world.