PSA Level and Result of Prostate Biopsy in 10 Years in Maharaj Nakorn Chiang Mai Hospital

Abstract

Introduction: Incidence of prostate cancer in Asia is less frequent than Europe and United States. There is no clearly defined incidence of prostate cancer in Thailand due to no nationwide screening campaign or lack of data registry in the past. We studied PSA level and prostate biopsy result in Maharaj Nakorn Chiang Mai hospital in the past 10 years for patient education.
Patient and Medthod: 913 patients who underwent prostate-specific antigen (PSA) test and prostate biopsies from January 2002 to Dec 2011 were recruited. Patients with urinary tract infection and acute urinary retention were excluded. The indications of prostate biopsy were abnormal digital rectal examination or abnormal PSA level. Percent of positive biopsy and sensitivity and specificity were recorded in different PSA level.
Results: Total number 913 patients. PSA level <4 ng/ml was found in 71 patients and detection rate of prostate cancer was 9.9% with sensitivity 97.85% and specificity 10.05%. PSA level 4-10 ng/ml was found in 322 patients and detection rate of prostate cancer was 16.8% with sensitivity 82.21% and specificity 55.88%. PSA level more than 10 ng/ml was found in 520 patients and detection rate of prostate cancer was 51.0% with sensitivity 81.29% and specificity 56.56%.
Conclusion: Increasing PSA level is associated with increasing prostate cancer incidence. PSA level is acceptable for screening and diagnosis of prostate cancer in Thailand. This information is important for patient education.