The Change of Clinical Characteristics of Prostatic Cancer before and after the Introduction of Prostate Specific Antigen Assay

Byun, Seok Su; Jo, Gyu Sun; Suh, Seung Il; Oh, Seung Jeon; Chung, Jin Soo; Lee, Sang Eun

Abstract

OBJECTIVE
To evaluate the change of clinical characteristics of prostatic cancer after the introduction of PSA (Prostate specific antigen) assay and TRUS (Transrectal ultrasonography), we retrospectively reviewed the medical records of 155 patients with prostatic adenocarcinoma who were managed at Seoul National University Hospital from January 1985 to December 1994.
MATERIALS AND METHODS
Patients were stratified into 2 groups (Group I: 45pts{1985-1989} and Group II: 110pts{1990-1994}) by the year 1990 when our hospital began to use PSA assay and TRUS to detect prostatic cancer. PSA was measured by monoclonal radioimmunometric assay (ELSA-PSA). Tumor staging consisted of DRE (digital rectal. examination), TRUS, CT, MRI, simple bone X-ray and radionuclide bone scan. Clinical characteristics of 2 groups were compared. RESULT: Proportion of younger pts increased in group II but this was not statistically significant (p>0.05 by chi-square test). Number of pts were annually increasing , especially after the year 1990 when PSA assay and TRUS were introduced into clinical practice. Despite use of PSA and TRUS, the number of clinically localized pts did not differ between 2 groups. There was no difference in distribution of chief complaints between 2 groups. There were 3 pts who were detected by increased PSA alone.
CONCLUSION
Prostate cancer incidence is increasing and will substantially increase in the future on the basis of increasing tendency to the old population, improved cancer detection and improved public awareness. More than 70% of pts have metastases or regional extension (Stage C or D). These dismal statistics constitute the main reason for early detection programs in the population at large.