Final Results of a Screening Campaign for Prostate Cancer
1999; Elsevier BV; Volume: 35; Issue: 1 Linguagem: Inglês
10.1159/000019815
ISSN1873-7560
AutoresE. Mart iacute n, M. Luj aacute n, E. S aacute nchez, A. Herrero, A. P aacute ez, Antonio Berenguer,
Tópico(s)Colorectal Cancer Screening and Detection
ResumoObjective: To detect curable prostate cancer in a male Spanish population. The results of screening 2,576 men are reported. Patients and Methods: Patients underwent digital rectal examination (DRE) and serum prostate-specific antigen (PSA) determination. Any patient with suspicious DRE or PSA >4 ng/ml was further evaluated with transrectal ultrasonography (TRUS) and biopsy. The sensitivity, specificity and predictive value of the tests or combinations of tests were determined. Results: Mean age was 59.9 years (median 58 years). Ninety-four patients (3.6%) had abnormal DRE while PSA was >4 ng/ml in 169 patients (6.5% of the total). We needed 6.8 biopsies to prove one cancer. PSA had the highest sensitivity (93%), whereas DRE had the highest specificity (97%). The positive predictive value rose to 78.9% when both DRE and PSA were abnormal. Clinically advanced tumor stages (≥ T3) were commoner (39.4%) than in similar series. Conclusions: PSA should be the first diagnostic test in a screening program for prostate cancer. Neither DRE nor TRUS are necessary in patients with PSA <4 ng/ml. In the light of our findings, we cannot encourage screening programs for prostate cancer for the time being.
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