Yonsei Med J.  2012 Nov;53(6):1136-1141. 10.3349/ymj.2012.53.6.1136.

Practice Patterns of Korean Urologists for Screening and Managing Prostate Cancer according to PSA Level

• Chung MS
• Lee SH
• Lee DH
• Kim SJ
• Kim CS
• Lee KS
• Jung JI
• Kim SW
• Lee YS
• Chung BH

• KMID: 1414255
• DOI: http://doi.org/10.3349/ymj.2012.53.6.1136

Abstract

PURPOSE
There are still debates on the benefit of mass screening for prostate cancer (PCA) by prostate specific antigen (PSA) testing, and on systemized surveillance protocols according to PSA level. Furthermore, there is a paucity of literature on current practice patterns according to PSA level in the Korean urologic field. Here, we report the results of a nationwide, multicenter, retrospective chart-review study.
MATERIALS AND METHODS
Overall 2122 Korean men (>40 years old, PSA >2.5 ng/mL) were included in our study (from 122 centers, in 2008). The primary endpoint was to analyze the rate of prostate biopsy according to PSA level. Secondary aims were to analyze the detection rate of PCA, the clinical features of patients, and the status of surveillance for PCA according to PSA level.
RESULTS
The rate of prostate biopsy was 7.1%, 26.3%, 54.2%, and 64.3% according to PSA levels of 2.5-3.0, 3.0-4.0, 4.0-10.0, and >10.0 ng/mL, respectively, and the PCA detection rate was 16.0%, 22.2%, 20.2%, and 59.6%, respectively. At a PSA level >4.0 ng/mL, we found a lower incidence of prostate biopsy in local clinics than in general hospitals (21.6% vs. 66.2%, respectively). A significant proportion (16.6%) of patients exhibited high Gleason scores (> or =8) even in the group with low PSA values (2.5-4.0 ng/mL).
CONCLUSION
We believe that the results from this nationwide study might provide an important database for the establishment of practical guidelines for the screening and management of PCA in Korean populations.

Keyword

Mass screening; prostate biopsy; prostate specific antigen

MeSH Terms

Aged
Asian Continental Ancestry Group
Biopsy
Humans
Male
Middle Aged
Physicians
Prostate-Specific Antigen/*blood
Prostatic Neoplasms/*blood/*diagnosis
Retrospective Studies
Urology

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