title: Lower urinary tract symptoms and risk of prostate cancer in Japanese men.
abstract: Our aim was to investigate whether or not men with lower urinary tract symptoms are at increased risk of prostate cancer. A total of 3511 men aged 50-79 years who underwent mass screening for prostate cancer between 2002 and 2004 for the first time, and completed the International Prostate Symptom Score (IPSS) questionnaire at the time of the prostate specific antigen (PSA) test, were enrolled in the present study. All men with PSA values greater than 4.0 ng/mL were advised and encouraged to undergo transrectal systematic sextant biopsy. The number of cancers subsequently detected was compared between men with IPSS scores of 0-7 and 8-35. Of the 3511 men, 219 (6.2%) had PSA values greater than 4 ng/mL, 178 (5.1%) underwent biopsy, and 51 (1.5%) were found to have prostate cancer. Although the PSA positivity rate for men with IPSS scores of 8-35 was significantly higher than that in the 0-7 group, there were no significant intergroup differences in the cancer detection rates for biopsied men and for total screened subjects. Multivariate logistic regression analysis revealed that prostate volume was the dominant predictor for the detection of prostate cancer, followed by PSA level, but the IPSS made no significant contribution. No significant difference was noted in the IPSS scores between men with cancer and the others of the same age group. Symptomatic Japanese men are not at higher risk of prostate cancer despite their higher PSA values compared with asymptomatic men of the same age group.
authors.affiliation: Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. matsua@hiroshima-u.ac.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yasumoto
authors.forename: Jun
authors.initials: J
authors.lastname: Teishima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Seki
authors.forename: Koji
authors.initials: K
authors.lastname: Mita
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Tateki
authors.initials: T
authors.lastname: Yoshino
authors.forename: Masao
authors.initials: M
authors.lastname: Kato
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Usui
mesh_terms: D000368:Aged; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D011446:Prospective Studies; D011467:Prostate / Q000033:anatomy & histology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D014555:Urination Disorders / Q000503:physiopathology*
chemical_list: D017430:Prostate-Specific Antigen