Population‐based screening for prostate cancer by measuring total serum prostate‐specific antigen in Iran

Hosseini, Seyed Yousef; Moharramzadeh, Massood; Ghadian, Alireza; Hooshyar, Hassan; Lashay, Ali R.; Safarinejad, Mohammad Reza

doi:10.1111/j.1442-2042.2006.01729.x

Cited by 23 publications

(25 citation statements)

References 44 publications

(80 reference statements)

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“…Despite the racial discrepancies in serum PSA reference [23][24][25][26][27], we noticed that the proportion of PSA abnormalities in Asian countries is comparable to that in Western countries (Table 4), which was reported to be approximately 10% of men when a threshold PSA value of 4.0 ng/ml was used [1][2][3]28]. In this study, we found that 8.40% of screened subjects had serum PSA levels C4.0 ng/ml, a value similar to that in most of the other screening studies worldwide [6,15,17,20,24,[29][30][31][32]. In a metaanalysis reported by Mistry and Cable [28], the pooled PPV of PSA (with a cut-off value of 4.0 ng/ml) in asymptomatic men older than 50 years was calculated as 25.1% (range 17.0-57.0%).…”

Section: Discussionmentioning

confidence: 99%

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

Hua

Qiao²,

et al. 2010

Med Oncol

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hua

Qiao²,

et al. 2010

Med Oncol

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“…1 In contrast to other Asian populations, 2,3 with a detection rate of 3.6-3.8%, the incidence of PCa in Iran is quite high. 4,5 It is well documented that genetic factors may account for as much as 42% of the PCa risk. 6 There are no consistent patterns of single chromosomal abnormalities in PCa; instead, the entire genome is apparently involved in prostatic carcinogenesis.…”

Section: Introductionmentioning

confidence: 99%

Glutathione S-transferase gene polymorphisms (GSTM1, GSTT1, GSTP1) and prostate cancer: a case-control study in Tehran, Iran

Safarinejad¹,

Shafiei²,

Safarinejad³

2011

Prostate Cancer Prostatic Dis

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We evaluated the relationship between polymorphisms in the glutathione S-transferases (GSTs) GSTM1, GSTT1 and GSTP1 genes and prostate cancer (PCa). PCR-restriction fragment length polymorphism assay was used to genotype the GSTM1, GSTT1, and GSTP1 polymorphisms in 168 PCa cases and 336 frequency matched controls. The GSTM1 null, and GSTT1 null genotypes were associated with an increased odds ratio (OR) for PCa (OR ¼ 3.28, 95% confidence interval (CI): 2.47-5.64; P ¼ 0.005, and OR ¼ 3.21, 95% CI: 2.52-5.64; P ¼ 0.005, respectively) (Pcorrected ¼ 0.0062). The frequency of GSTP1 Val/Val genotype was 14.3% in cases compared with 2.4% in controls, this polymorphism thus being associated with a significantly increased risk of PCa (OR ¼ 3.72, 95% CI: 1.67-5.65; P ¼ 0.002). The risk associated with the concurrent absence of both of the genes (OR ¼ 4.8, 95% CI: 2.34-6.78) was greater than the product of risk in men with either null (OR ¼ 1.52, 95% CI: 0.82-2.31) genotype combinations (P ¼ 0.001, Pcorrected ¼ 0.0045). The combination of GSTP1 Ile/Val or Val/Val polymorphism with the GSTT1 null and GSTM1 null type resulted in an OR of 6.21 (95% CI: 4.83-16.87) (P ¼ 0.0001, Pcorrected ¼ 0.0062). A higher frequency of the GSTM1 null genotype and GSTT1 null genotype was observed in patients with Gleason score 47, with an OR for GSTM1 null 4.67 (95% CI: 3.64-7.62; P ¼ 0.001) and with an OR for GSTT1 null 3.62 (95% CI: 2.31-5.74; P ¼ 0.004). The results obtained demonstrated that simultaneous presence of three potentially risk alleles (GSTM1 null, GSTT1 null and GSTP1 Val) lead to a significant OR increase for PCa.

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“…20 The lowest recorded PCa rate is 0.4 per 100 000 in Ardabil, northwest Iran. 13,21 Iranian men are ethnically and racially different from most of Asian men, 22 so the biochemical parameters of PCa should be different. In a study by Khezri et al, 23 in a large Iranian healthy male population, the serum PSA concentration correlated directly with the subject's age and prostatic volume.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, a total of 346 males with increased PSA values with or without positive DRE (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) A sextant biopsy was performed from the apex and base of the right and left parasagittal planes of the prostate with 10 core biopsies. If hypoechoic areas were noted on TRUS, a specimen was taken from each of these areas.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of prostate cancer prevalence in Iranian male population with increased PSA level, a one center experience

Moslemi¹,

Lotfi²,

Zargar³

2011

CMAR

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Purpose: This study was conducted to evaluate the incidence of prostate cancer (PCa) in Iranian male patients with increased prostate-specific antigen (PSA), and normal or abnormal digital rectal examination (DRE) that underwent prostate biopsy. Materials and methods: From March 2006 to April 2009, a total of 346 consecutive males suspected of having PCa due to increased PSA levels underwent transrectal ultrasonography (TRUS)-guided sextant biopsy of the prostate. The total PSA (tPSA), demographic data, incidence of PCa, benign prostate hyperplasia (BPH), and prostatitis were assessed. Results: The patients were divided into two groups according to their PSA values (group A serum tPSA level, 4-10 ng/mL; group B serum tPSA level, 10.1-20.0 ng/mL). Of the 346 biopsied cases, 193 cases (56%) had PCa, 80 cases (23%) had BPH, and 73 cases (21%) had prostatitis. The mean PSA and the age of the carcinoma group were significantly higher than those of the benign group (P , 0.01). The biopsy results were grouped as PCa, BPH, and prostatitis. Incidence of PCa for group A and group B cases were 115 cases (51%), and 78 cases (65%), respectively. In the case of PCa, BPH, and prostatitis, the mean PSAs were 10.02 ng/mL, 8.76 ng/mL, and 8.41 ng/mL, respectively (P , 0.40). Conclusion: TRUS-guided prostate biopsy and interpretation by a skilled team is highly recommended for early detection of PCa or its ruling-out. It seems that a PSA cutoff value of 4 ng/mL may be applied to the Iranian population. Although the chance of PCa is high in the PSA levels of 4-10 ng/mL, the combination of some data, like age and prostate volume, can decrease the rate of unnecessary prostate biopsies. We recommend prostate biopsy when PSA and/or DRE is elevated in symptomatic patients with obstructive and/or irritative lower urinary tract symptoms (LUTS) such as dysuria, frequency, or nocturia. Due to the very high incidence of PCa in the patients with PSA greater than 10 ng/mL, TRUS-guided biopsy is indicated, whatever the findings on DRE and/or LUTS, since the PCa detection rate is high.

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Population‐based screening for prostate cancer by measuring total serum prostate‐specific antigen in Iran

Cited by 23 publications

References 44 publications

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

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

Glutathione S-transferase gene polymorphisms (GSTM1, GSTT1, GSTP1) and prostate cancer: a case-control study in Tehran, Iran

Evaluation of prostate cancer prevalence in Iranian male population with increased PSA level, a one center experience

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