Urologic Malignancy Detected by Routine Check-up at a Health Promotion Center

Doo, Chin kyung; Park, Sung chan; Kim, Choung Soo

Abstract

PURPOSE: The efficiency of the initial screening methods for the detection of urologic malignancies was evaluated with regard to each cancer detection rate.
MATERIALS AND METHODS
Of the 117,023 people (Male:Female=1.5:1) who received general health examinations between 2000 and 2003, 4,000 (3.42%) were referred to the department of urology. It was recommended that the referred patients receive the following additional tests: intravenous pyelography (IVP) and cystourethroscopy for microscopic hematuria, a prostate biopsy after digital rectal examination to elevate prostate-specific antigen (PSA) above 4ng/ml and dynamic computerized tomography of the kidney for any abnormality on the ultrasonography.
RESULTS
A microscopic hematuria was detected in 2,253 people (1.93%), PSA evaluated in 620 (0.89%) and an abnormality of the kidney on ultrasonography in 1,127 (0.96%). One diagnosis was of a bladder tumor, which turned out to be a pTaG2. Twenty seven were found to have prostate cancer, which was organ confined in 13, locally advanced in 7 and systemically advanced in 3. Four men refused further evaluation or management. A renal cell carcinoma (stages pT1a-bN0M0G1-3) was diagnosed in the 10 people having undergone partial or radical nephrectomies and 2 having undergone a nephroureterectomy were diagnosed with a transitional cell carcinoma (stages pT1 and 3bN0M0G3) of the renal pelvis.
CONCLUSIONS
In the screening of kidney and bladder cancers, the detection rates and cancer stages attributed to ultrasonography and microscopic hematuria are lower. However, the rates of prostate cancer detected by PSA, and their stage, both seem to be higher. It is our belief that greater information and an earlier PSA test will allow the detection of prostate cancer at a lower stage.