scholarly journals Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

2021 ◽  
Vol 93 (1) ◽  
pp. 92-100
Author(s):  
Andrea B. Galosi ◽  
Erika Palagonia ◽  
Simone Scarcella ◽  
Alessia Cimadamore ◽  
Vito Lacetera ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Practice ◽  
Early Stage ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Point Of View ◽  
Italian Society ◽  
Rectal Examination ◽  
Normal Limits ◽  
Low Serum

Reasons why significant prostate cancer is still missed in early stage were investigated at the 22nd National SIEUN (Italian Society of integrated diagnostic in Urology, Andrology, Nephrology) congress took place from 30th November to 1st December 2020, in virtual modality. Even if multiparametric magnetic resonance (MR) has been introduced in the clinical practice several, limitations are emerging in patient with regular digital rectal examination (DRE) and serum prostate specific antigen (PSA) levels approaching the normal limits. The present paper summarizes highlights observed in those cases where significant prostate cancer may be missed by PSA or imaging and DRE. The issue of multidisciplinary interest had been subdivided and deepened under four main topics: biochemical, clinical, pathological and radiological point of view with a focus on PI-RADS 3 lesions.

scholarly journals Clinical diagnosis of prostate cancer using digital rectal examination and prostate-specific antigen tests: a systematic review and meta-analysis of sensitivity and specificity

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nelson C. Okpua ◽  
Simon I. Okekpa ◽  
Stanley Njaka ◽  
Augusta N. Emeh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Antigen Test ◽  
Rectal Examination ◽  
Prostate Specific Antigen Test ◽  
Prostate Cancers ◽  
Antigen Tests

Abstract Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.

scholarly journals Integrated predictive model for prostatic cancer using clinical, laboratory and ultrasound data

2016 ◽  
Vol 43 (6) ◽  
pp. 430-437
Author(s):  
GUSTAVO DAVID LUDWIG ◽  
HENRIQUE PERES ROCHA ◽  
LÚCIO JOSÉ BOTELHO ◽  
MAIARA BRUSCO FREITAS
Keyword(s):  
Prostate Cancer ◽  
Predictive Model ◽  
Prostate Biopsy ◽  
Clinical Laboratory ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Roc Curves ◽  
Rectal Examination ◽  
Psa Density

ABSTRACT Objective: to develop a predictive model to estimate the probability of prostate cancer prior to biopsy. Methods: from September 2009 to January 2014, 445 men underwent prostate biopsy in a radiology service. We excluded from the study patients with diseases that could compromise the data analysis, who had undergone prostatic resection or used 5-alpha-reductase inhibitors. Thus, we selected 412 patients. Variables included in the model were age, prostate specific antigen (PSA), digital rectal examination, prostate volume and abnormal sonographic findings. We constructed Receiver Operating Characteristic (ROC) curves and calculated the areas under the curve, as well as the model's Positive Predictive Value (PPV) . Results: of the 412 men, 155 (37.62%) had prostate cancer (PC). The mean age was 63.8 years and the median PSA was 7.22ng/ml. In addition, 21.6% and 20.6% of patients had abnormalities on digital rectal examination and image suggestive of cancer by ultrasound, respectively. The median prostate volume and PSA density were 45.15cm3 and 0.15ng/ml/cm3, respectively. Univariate and multivariate analyses showed that only five studied risk factors are predictors of PC in the study (p<0.05). The PSA density was excluded from the model (p=0.314). The area under the ROC curve for PC prediction was 0.86. The PPV was 48.08% for 95%sensitivity and 52.37% for 90% sensitivity. Conclusion: the results indicate that clinical, laboratory and ultrasound data, besides easily obtained, can better stratify the risk of patients undergoing prostate biopsy.

Comparing Two Modalities of Screening for Prostate Cancer: Digital Rectal Examination + Transrectal Ultrasonography Vs. Prostate-Specific Antigen

1995 ◽  
Vol 81 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Stefano Ciatto ◽  
Rita Bonardi ◽  
Antonia Mazzotta ◽  
Claudio Lombardi ◽  
Roberto Santoni ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Transrectal Ultrasonography ◽  
Attendance Rate ◽  
Predictive Values ◽  
Rectal Examination ◽  
Biopsy Rate

Aims and background To evaluate the performance and feasibility of screening for prostate cancer by comparing screening modalities. Methods Prospective study of two comparable cohorts of healthy resident males aged 60 to 75 years. Screening attenders in the two invited cohorts were screened either by digital rectal examination (DRE) and transrectal ultrasonography (TRUS), or by serum prostate-specific antigen determination (PSA: cutoff 4 ng/ml). Attendance and biopsy rates, predictive values, prevalence of screen-detected cancers, as well as screening costs were determined, and the efficiency of the two screening modalities was compared. Results 1425 subjects were screened by DRE + TRUS. Attendance rate was 33.7%, the biopsy rate was 2.7%, and the prevalence of detected cancers was 1.82%. A total of 1315 subjects was screened by PSA. Attendance rate was 66.9%, the biopsy rate was 2.8%, and the prevalence of detected cancers was 1.67%. Screen-detected cancer stage was more favorable than observed in clinical practice, and early detection was evident, with the prevalence/incidence ratio higher than 10:1 in both programs. The cost per subject screened was about 34,000 Lire for DRE + TRSU and about 30,000 Lire for PSA program. Conclusions The study confirms that early detection of prostate cancer is possible and that screening is practically feasible. Both screening modalities achieved comparable results as regards early detection, but screening by PSA had a higher compliance and lower costs. PSA seems the ideal test to be used in prospective controlled studies aimed at demonstrating screening efficacy.

Occupation as a predictor of prostate cancer screening behaviour in Canada

2020 ◽  
Vol 27 (4) ◽  
pp. 215-222
Author(s):  
Cheryl E Peters ◽  
Paul J Villeneuve ◽  
Marie-Élise Parent
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Specific Antigen ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Antigen Test ◽  
Screening Practices ◽  
Rectal Examination ◽  
Prostate Specific Antigen Test

Objectives If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005–2012). Methods Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. Results Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10–0.65), construction (0.44, 0.25–0.79), machining (0.45, 0.21–0.97), and teaching (0.37, 0.20–0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. Conclusions Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.

scholarly journals Relationship of Prostate Specific Antigen and Digital Rectal Examination in the Prediction of Prostate Cancer

2020 ◽  
Vol 16 (2) ◽  
pp. 83-87
Author(s):  
Bhusan Raj Timilsina ◽  
Gaurav Devkota ◽  
Shweta Giri ◽  
Sulav Pradhan ◽  
Sudeep RaJ KC
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Rectal Examination ◽  
Relationship Of

Background: Prostate cancer is one of the most common and leading cause of death among different genitourinary causes. However, screening of prostate cancer is limited to Digital Rectal Examination (DRE) and Prostate Specific Antigen (PSA) in Nepal. The aim of this study is to find out which modality is more helpful for the diagnosis of Prostate Cancer. Methods: A retrospective cross-sectional study was conducted in the department of Urology, College of Medical Sciences, Chitwan, Nepal. All patients included in this study were who presented to the OPD with Lower Urinary Tract Symptoms (LUTS). The patients were above the age of 40 with clinical suspicion prostate cancer based on either DRE or PSA.   Results: A total of 150 patients were enrolled from April 2019 to April 2020. Their mean± SD age was of 65.18±9.38 years. The accuracy of the diagnostic test for DRE and PSA were cut off at 4, PSA cut off range of 4 to 10, PSA cut off range of 10 to 30 and PSA cut off at 30 showed that all the screening indices were better for DRE (Sensitivity=100%, Specificity=59.2%, Diagnostic Accuracy=62.2%) than for PSA cut off at 4 (Sensitivity=100%, Specificity=27.6%, Diagnostic Accuracy=32.9%). Among various cut off score or ranges for PSA, cut off score at 30 provided the best screening indices with Sensitivity of 66.7%, Specificity of 97.4% and Diagnostic Accuracy of 95.1%. Conclusions: PSA has higher diagnostic accuracy then DRE. Keywords: DRE; LUTS; Prostate cancer; PSA.  

scholarly journals Prostate Cancer Education, Detection, and Follow-Up in a Community-Based Multiethnic Cohort of Medically Underserved Men

2016 ◽  
Vol 11 (1) ◽  
pp. 82-91 ◽  
Author(s):  
Omotola S. Ashorobi ◽  
Jacqueline Frost ◽  
Xuemei Wang ◽  
Pamela Roberson ◽  
E. Lin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Cancer Education ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Medically Underserved ◽  
Underserved Communities ◽  
Rectal Examination ◽  
Multiethnic Cohort

The Prostate Outreach Project (POP) provided free prostate cancer (PCa) education and early detection to medically underserved communities. POP recruited participants in medically underserved communities. PCa education and detection events occurred in POP locations (static) or natural gathering places (mobile) within the community. PCa education was delivered by video and evaluated using a questionnaire. Screening consisted of serum prostate-specific antigen and digital rectal examination. A navigated follow-up strategy was utilized to provide medical care for participants with abnormal screening examinations (ASE). POP recruited 4,420 men, 62.8% (2,667) were African American (AA). Most participants had a high school education and no prior screening. Fifty-four percent (2,159) were uninsured and 41% (1,811) had no access to a physician. PCa knowledge increased following the educational video. Prostate-specific antigen levels were elevated in 9.8% (436), while 6.9% (233) had an abnormal digital rectal examination. Follow-up among 609 men with ASE was successful in 40% (244), despite a navigated approach. Overall, 3.3% (144) cancers were diagnosed among the POP with AA participants exhibiting a significantly higher incidence. Recruitment, education, and PCa testing among a medically underserved cohort was successful. However, failure to follow through on ASE could contribute to maintaining the disparity in PCa outcomes noted among AAs and the medically underserved if not addressed.

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