Utility of Digital Rectal Examination, Serum Prostate Specific Antigen, and Transrectal Ultrasound in the Detection of Prostate Cancer: A Developing Country Perspective

Abstract

Purpose: To determine the utility of digital rectal examination (DRE), serum total prostate specific antigen (tPSA) estimation, and transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) in men with lower urinary tract symptoms (LUTS). Materials and Methods: All patients with abnormal DRE, TRUS, or serum tPSA >4ng/ml, in any combination, underwent TRUS-guided needle biopsy. Eight cores of prostatic tissue were obtained from different areas of the peripheral prostate and examined histopathologically for the nature of the pathology. Results: PCa was detected in 151 (50.3%) patients, remaining 149 (49.7%) showed benign changes with or without active prostatitis. PCa was detected in 13 (56.5%), 9 (19.1%), 26 (28.3%), and 103 (74.6%) of patients with tPSA <4 ng/ml, 4-10 ng/ml, 10-20 ng/ml and >20 ng/ml respectively. Only 13 patients with PCa had abnormal DRE and TRUS with serum PSA <4 ng/ml. The detection rate was highest in patients with tPSA >20 ng/ml. The association between tPSA level and cancer detection was statistically significant (p<0.01). Among 209 patients with abnormal DRE and raised serum PSA, PCa was detected in 128 (61.2%). Conclusions: The incidence of PCa increases with increasing serum level of tPSA. The overall screening and detection rate can be further improved by using DRE, TRUS and TRUS-guided prostate needle biopsies.

Current and Future Applications of Genetic Prostate Cancer Screening In the Urologic Clinic

“…A decline in prostate cancer mortality has been observed since the Food and Drug Admini stration approved the use of the PSA test. Additionally, implementing PSA testing has allowed diagnosis of the disease at a much earlier and potentially more curable stage (Gulati et al, 2013;Kash, Lal, Hashmi, & Mubarak, 2014;Pashtan, Chen, & D'Amico, 2014). Some studies, however, have attributed the decline in prostate cancer mortality in the U.S. to improvements in cancer treatment (Etzioni & Feuer, 2008).…”

Big Medical Data Decision-Making Intelligent System Exploiting Fuzzy Inference Logic for Prostate Cancer in Developing Countries

“…Proportionately, in China, over 5000 patients must share one physician, and one general practitioner needs to take care of at least 70 prostate cancer patients a day [9], [10]. Over the whole diagnosis cycle, a mass of multimodal medical data associated with prostate cancer will be extracted, but only 30% of these statistics can be useful for the detection, diagnosis, and prognosis of the disease [11].…”

MicroRNA‑106b functions as an oncogene and regulates tumor viability and metastasis by targeting LARP4B in prostate cancer

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