Detection Rate and Clinical Pattern of Prostate Cancer in Kuwait: A Single-Center Experience

Arun, Narayanaswamy; Abul, Fawzi; Mathew, T.C.

doi:10.1159/000319762

Cited by 4 publications

(7 citation statements)

References 42 publications

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“…The cancer detection rate in this study increases with increase in the PSA levels [ Table 2 ]. This finding is in tandem with the findings of Jia et al [ 15 ] in China and Narayanaswamy[ 22 ] et al in the Middle East. The cancer detection rate of 25.0% at PSA range of 4.0–10.0 ng/ml in this study, was consistent with other studies from the Western world and the Eastern hemisphere as well as similar studies from our locality.…”

Section: Discussionsupporting

confidence: 90%

“…[ 15 ] The prostate cancer detection rate increased proportionately with increase in prostate volume [ Table 3 ]. This observation is at variance with that of Narayanaswamy et al [ 22 ] who reported a decreased detection rate with increasing prostate volume with the majority of the cancer patients having the prostate volume of <50.0 g.…”

Section: Discussioncontrasting

confidence: 87%

“…This difference may be due to the six core biopsy protocol used in that study which has been noted to give a lower detection rate compared to the extended 12 core biopsy regimen. [ 11 12 14 16 ] In men with PSA levels >10 ng/ml, the detection rate of 66.4% is higher than the 40% reported in the Kuwaiti men[ 22 ] and the 59.5% rate reported in Korean men[ 24 ] but comparable with the 67% detection rate reported among the Americans. [ 25 ] This comparable high rate may be explained by the proposition of some scholars that there exists an endemic hereditary predilection connecting the American blacks and the Africans[ 26 ] and further buttresses the existence of some natural elements in our surroundings that may be amplifying the inheritable factors thought to be responsible for prostate cancer.…”

Section: Discussionmentioning

confidence: 87%

“…Similar studies in Kuwait and China reported similar findings though with lower detection rates. [ 15 22 ] The likely reason for this marked difference may be the absence of comprehensive population-based prostate cancer screening program in sub-Saharan Africa due to limited resources. [ 5 6 ] As a result of this, many prostate cancer patients in our environment present late with features of local invasion or distant metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Detection rate of prostate cancer following 12-core extended biopsy in a Semi-urban Nigerian Tertiary Hospital

Ogbetere

Irekpita

2021

Urol Ann

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Background: Transrectal prostate biopsy using the extended protocol has become the standard mode of obtaining tissue for histological diagnosis with cancer detection rate varying with race and geographical regions. This study is aimed at evaluating the cancer detection rate following a 12-core extended transrectal biopsy of the prostate in a semi-urban Nigerian tertiary hospital. Materials and Methods: This was a hospital-based prospective study. Patients who had one or combination of elevated prostate-specific antigen (PSA) levels, abnormal digital rectal examination (DRE), and suspicious ultrasound findings were recruited into this study. Each had 12-core extended biopsy done. Their clinical and histological information were recorded in a pro forma. Data analysis was performed using the statistical programming for social sciences (SPSS) version 21. For all statistical tests, P < 0.05 was regarded as significant. Results: Of the 120 patients, 78 (65%) had prostate cancer. The cancer detection rate in participants aged 50–59, 60–69, 70–79, 80–89, 90–100 were 75%, 46.7%, 72.3%, 85.7%, and 100%, respectively. Overall, the cancer detection rate at PSA levels 4.0–10.0 was 25%, 10.1–20.0 was 54.7%, 20.1–50.0 was 67.4%, 50.1–100.0 was 100%, and >100.0 was 100%. The cancer detection rate for men with suspicious DRE and prostatic ultrasound findings were comparatively higher than those with normal DRE and prostatic ultrasound findings at similar PSA levels. Conclusion: This study showed a higher cancer detection rate with a 12-core biopsy protocol when compared to similar studies from the Western world, the Middle East, and urban centers in Nigeria due to poor awareness and late presentation in our environment.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Detection rate of prostate cancer following 12-core extended biopsy in a Semi-urban Nigerian Tertiary Hospital

Ogbetere

Irekpita

2021

Urol Ann

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“…In our study we have further strati ed the grey zone levels into 4 categories and analysed each category statistically.Many studies from other countries all over Asia have reported wide variations in the TRUS biopsy yield. large retrospective study from China by Na R et al, reported lower yield for patients with serum PSA less than 10 ng/mL and (10-20) ng/mL despite overall high yield11 . Two studies from Singapore by Lee et al, and Teo et al, con rmed the lower yield for serum PSA below 10 ng/mL which was less than 21%12,13 .…”

mentioning

confidence: 99%

Redefining Serum PSA Cut-off in Indian Population to Avoid Unnecessary Biopsies - A Descriptive Study

Prakash

Vetrichandar

et al. 2021

Preprint

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INTRODUCTION: Prostate cancer is the second most common cancer diagnosed in men with an estimated 1.2 million diagnoses worldwide. The incidence of Prostate cancer is higher in western countries and low in Asian countries. The need for prostate biopsy is based on PSA levels. The general cut off PSA value for the Indian population is 4.0 ng/mL. The reported cancer detection rate of TRUS-guided biopsies is around 30 percent in western countries and lesser in Asian countries, including India, particularly for serum PSA values less than 20 ng/mL indicating that many of the Indian patients are subjected to unnecessary biopsy which adds up to distress to these patients.PURPOSE: To determine the cancer detection rate of TRUS-guided prostate biopsy in the Indian population at different serum Prostate-Specific Antigen levels and determine a PSA cut-off level to avoid unnecessary biopsies.MATERIALS AND METHODS:All symptomatic patients who underwent TRUS guided biopsy for raised serum PSA levels between 4 - 20 ng/mL were included. The patients were categorized into four groups corresponding to the PSA levels ranging between 4-6 ng/mL, 6- 8 ng/mL, 8-10 ng/mL, and 10-20 ng/mL respectively, and cancer detection rate in each group were statistically analyzed.RESULTS:The sensitivity, specificity, and positive predictive value of TRUS guided biopsy are 75%, 95%, and 98% respectively in our study. The overall cancer detection rate of TRUS biopsy in our series was 18.4%. The PSA cut-off to do biopsy was derived by ROC curve as 8.9 ng/ml for all the men. CONCLUSION: The PSA cut-off of 4.0 ng/mL is currently used as an indication for biopsy among men of all ages in the Indian population. We recommend a raise in cut-off to 8.9 ng/mL to avoid unnecessary TRUS-guided biopsies in the Indian population.

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The Role of PSA Density among PI-RADS v2.1 Categories to Avoid an Unnecessary Transition Zone Biopsy in Patients with PSA 4-20 ng/mL

Wang

Wei

Zhang

et al. 2021

BioMed Research International

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Objective. To evaluate the role of prostate-specific antigen density (PSAD) in different Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) categories to avoid an unnecessary biopsy in transition zone (TZ) patients with PSA ranging from 4 to 20 ng/mL. Materials and Methods. In this retrospective and single-center study, 333 biopsy-naïve patients with TZ lesions who underwent biparametric magnetic resonance imaging (bp-MRI) were analyzed from January 2016 to March 2020. Multivariate logistic regression analyses were performed to determine independent predictors of clinically significant prostate cancer (cs-PCa). The receiver operating characteristic (ROC) curve was used to compare diagnostic performance. Results. PI-RADS v2.1 and PSAD were the independent predictors for TZ cs-PCa in patients with PSA 4-20 ng/mL. 0.9% (2/213), 10.0% (7/70), and 48.0% (24/50) of PI-RADS v2.1 score 1-2, 3, and 4-5 had TZ cs-PCa. However, for patients with PI-RADS v2.1 score 1-2, there were no obvious changes in the detection of TZ cs-PCa (0.8% (1/129), 1.3% (1/75), and 0.0% (0/9)) combining with different PSAD stratification ( PSAD < 0.15 , 0.15-0.29, and ≥0.30 ng/mL/mL). For patients with PI-RADS v2.1 score ≥ 3 , the TZ cs-PCa detection rate significantly varied according to different PSAD stratification. A PI-RADS v2.1 score 3 and PSAD < 0.15 and 0.15-0.29 ng/mL/mL had 8.6% (3/35) and 3.7% (1/27) of TZ cs-PCa, while a PI-RADS v2.1 score 3 and PSAD ≥ 0.30 ng / mL / mL had a higher TZ cs-PCa detection rate (37.5% (3/8)). A PI-RADS v2.1 score 4-5 and PSAD <0.15 ng/mL/mL had no cs-PCa (0.0% (0/9)). In contrast, a PI-RADS v2.1 score 4-5 and PSAD 0.15-0.29 and ≥0.30 ng/mL/mL had the highest cs-PCa detection rate (50.0% (10/20), 66.7% (14/21)). It showed the highest AUC in the combination of PI-RADS v2.1 and PSAD (0.910), which was significantly higher than PI-RADS v2.1 (0.889, P = 0.039 ) or PSAD (0.803, P < 0.001 ). Conclusions. For TZ patients with PSA 4-20 ng/mL, PI-RADS v2.1 score ≤ 2 can avoid an unnecessary biopsy regardless of PSAD. PI-RADS v2.1 score ≥ 3 may avoid an unnecessary biopsy after combining with PSAD. PI-RADS v2.1 combined with PSAD could significantly improve diagnostic performance.

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Detection Rate and Clinical Pattern of Prostate Cancer in Kuwait: A Single-Center Experience

Cited by 4 publications

References 42 publications

Detection rate of prostate cancer following 12-core extended biopsy in a Semi-urban Nigerian Tertiary Hospital

Detection rate of prostate cancer following 12-core extended biopsy in a Semi-urban Nigerian Tertiary Hospital

Redefining Serum PSA Cut-off in Indian Population to Avoid Unnecessary Biopsies - A Descriptive Study

The Role of PSA Density among PI-RADS v2.1 Categories to Avoid an Unnecessary Transition Zone Biopsy in Patients with PSA 4-20 ng/mL

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