[Results of a screening program for prostatic cancer].
OBJECTIVE
To set up the epidemiology of prostate cancer in the geographical area of Getafe, Madrid (Spain) and to detect curable prostate cancer. The results of screening 2.576 men are reported.


METHODS
Patients underwent digital rectal examination (DRE) and PSA determination. Patients with suspicious DRE or PSA greater than 4 ng/ml were further evaluated with transrectal ultrasonography (TRUS) and biopsy. The diagnostic performances of the tests or combinations of tests were determined.


RESULTS
Mean age was 59.9 years (median 58 years). Ninety-four patients (3.6 per cent) had abnormal DRE while PSA was higher than 4 ng/ml in 169 patients (6.5% of the total). 6.8 biopsies were needed to prove one cancer. The higher sensitivity corresponded to the PSA (93%). The test of greatest specificity was the rectal examination (97%). Positive predictive value raised to 78.9% when both DRE and PSA were abnormal. Advanced tumor stages were more common (39.4%) than in previous experiences.


CONCLUSIONS
PSA should be the first diagnostic test when screening for prostate cancer. Neither the DRE nor the TRUS have any place in patients with PSA below 4 ng/ml. In summary we can't encourage screening programs for prostate cancer so far.
Martín Oses
E
E
Servicio de Urología, Hospital Universitario de Getafe, Madrid.
Luján Galán
M
M
Sánchez Sánchez
E
E
Herrero Payo
A
A
Páez Borda
A
A
Berenguer Sánchez
A
A
D000368:Aged; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D012680:Sensitivity and Specificity
Resultado de un programa de screening para el cáncer de próstata.