Objective To assess whether it is worthwhile to screen asymptomatic men for prostate cancer using serum prostate specific antigen (PSA) and to determine how many patients could be cured of prostatic carcinoma if detected by screening.
Patients and method Between june 1992 and january 1994 the serum PSA level of 1400 asymptomatic men over 50-years-old was assessed.
Those men with PSA levels<4 ng/mL were not evaluated further.
Those men with PSA levels of 4-10 ng/mL underwent digital rectal examination and transrectal ultrasonography (TRUS) and biopsies were taken when there were significant findings on DRE and/or TRUS.
Where cancer was detected the tumour was staged and if it was a clinically confined tumour a radical retropubic prostatectomy was performed.
The pathological and clinical stages of the disease were then compared.
Results The majority of patients (95%) had PSA levels of<4 ng/mL.
Forty-nine men had PSA levels of 4-10 ng/mL and of these 28 were biopsied, which detected 12 (24.5%) carcinomas.
There were 20 men with PSA levels>10 ng/mL and among them 11 (55%) were found to have carcinomas.
Combining these figures, among the 1400 men there were 69 cases with PSA levels>4 ng/mL and, using DRE and TRUS, 2 3 patients (33%) were diagnosed as having prostatic adenocarcinomas.
Conclusion Only eight patients can be considered as cured because of the screening protocol and even this result is overoptimistic, as the future biological behaviour of these tumours is unknown.
Mots-clés Pascal : Tumeur maligne, Prostate, Homme, Diagnostic, Semenogelase, Phase initiale, Efficacité, Mâle, Dépistage, Indication, Serine endopeptidases, Proteinases, Hydrolases, Enzyme, Prostate pathologie, Appareil urinaire pathologie, Appareil génital mâle pathologie
Mots-clés Pascal anglais : Malignant tumor, Prostate, Human, Diagnosis, Semenogelase, Early phase, Efficiency, Male, Medical screening, Indication, Serine endopeptidases, Proteinases, Hydrolases, Enzyme, Prostate disease, Urinary system disease, Male genital diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0343168
Code Inist : 002B30A03B. Création : 01/03/1996.