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Prostate cancer screening - results of the studies
Article published in Urologia Polska 2004/57/4.

authors

Jakub Dobruch 1, Andrzej Borówka 1, Artur A. Antoniewicz 1, Piotr Chłosta 2
1 Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego, I Zespół Dydaktyki Urologicznej - Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie
Kierownik kliniki i ordynator oddziału: prof. dr hab. Andrzej Borówka
2 Dział Urologii ¦więtokrzyskiego Centrum Onkologii w Kielcach
Kierownik działu: dr med. Stefan Olszewski

keywords

prostate, prostate cancer, screening, PSA, mortality

summary

Screening for prostate cancer (PCa) allows to distinguish men with organ confined prostate cancer in whom radical treatment leading to complete cancer removal may be performed. However, before mass screening is carried out its efficiency in reduction of disease specific mortality must be proven.
The purposes of the present study were evaluation of diagnostic efficacy of prostate cancer screening, identification of diagnostic methods most valuable for screening and demonstration whether prostate screening is reasonable.
The results of the studies presented in MEDLINE regarding the prostate cancer screening involving large number of men and evaluating the diagnostic efficacy of various tests were analyzed.
Prostate biopsy was performed in most of the studies in case of: increased plasma PSA and abnormal digital rectal examination (DRE). Icreased PSA and/or suggestive of prostate cancer DRE was observed respectively in 3,1-19,5% and 3-10% of screened men. Prostate cancer was diagnosed in majority of cases in men in whom biopsy was preformed because of increased PSA. Finaly PCa was present in 24-33% of men subjected to prostate biopsy. However clinical and pathological characteristics of PCa detected by screening were more favourable than characteristics of PCa detected in not screened population of men.
Cyclic PSA measurements are most valuable screening test for prostate cancer. It is performed only in men at the age suitable for radical treatment. Prostate cancer screening leads to increase in men dignosed with PCa. It also leads to increase in percentage of organ confined and well differentiated prostate cancer. Therefore it is possible to distinguish men in whom prostate cancer may be radically treated. However the data indicating that prostate cancer screening decreases disease specific mortality is still lacking.

references

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correspondence

Jakub Dobruch
Oddział Urologii Centralnego Szpitala Kolejowego
ul. Bursztynowa 2
04-749 Warszawa
tel. 0 503 072 230