Incidence of prostate cancer in Sicily: results of a multicenter case-findings protocol.
OBJECTIVE
To establish the incidence of prostate cancer (PCa) in Sicily in patients who entered an early detection protocol.


METHODS
From February 2002 to February 2004, 16,298 subjects aged 40-75 entered the protocol. Patients with suspicious DRE, PSA>10 ng/ml, PSA<or=2.5 ng/ml, from 2.6 to 4 ng/ml or from 4.1 to 10 ng/ml with F/T PSA of <or=15%, <or=20% and <or=25% respectively underwent needle biopsy according to an extensive protocol.


RESULTS
3266 patients were eligible for biopsy; PSA was <or=4 in 12.7% and <or=10 ng/ml in 63.9% of patients. A PCa was found in 1171 cases (36.9%) with a relationship between PCa incidence and PSA and age respectively (chi2-test, p<0.0001); 51.8% of patients with PCa had a PSA<10 and 8.8% a PSA<4 ng/ml; 49% were clinically staged as T1c. The estimated odds ratios for each age group showed increased risk for PCa in the fourth decade with PSA between 2.6 and 4 ng/ml (12.5 times higher) and in the fifth decade with PSA between 4.1 and 10 ng/ml (6.2 times higher).


CONCLUSIONS
Age and serum PSA levels are the major risk factors for PCa. On their basis it is possible to modulate the most suitable timing for early diagnosis in individual patients.
Aragona
F
F
Urology Unit, Azienda Ospedaliera Cannizzaro, Via Messina 829, 95126 Catania, Italy. frank.aragona@virgilio.it
Pepe
P
P
Motta
M
M
Saita
A
A
Raciti
G
G
La Rosa
P
P
Nicolosi
D
D
Dammino
A
A
Minaldi
G
G
Rizza
G
G
Azzarello
G
G
Aragona
C
C
Rotondo
S
S
Orestano
L
L
Serrao
A
A
Amico
F
F
Dibenedetto
G
G
Cosentino
V
V
Iurato
C
C
Raffino
S
S
Gulletta
M
M
Calarco
A
A
Paola
Q
Q
Barbera
M
M
Gulino
V
V
Capizzi
G
G
Orestano
F
F
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010173:Palpation / Q000379:methods; D015995:Prevalence; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012802:Sicily / Q000453:epidemiology; D014463:Ultrasonography
D017430:Prostate-Specific Antigen