title: Incidence and pathological characteristics of prostate cancer in Italy: a contribution to the screening debate.
abstract: BACKGROUND
  The scientific, social and financial aspects of prostate cancer (PC) organized or opportunistic screening to identify early PC are hotly debated. The incidence of prostate cancer is lower in Italy than in America and North Europe and data on PC incidence and pathological characteristics are scarce.
  
  
  METHODS
  To determine PC incidence and whether screening would be beneficial, we studied 1008 consecutive symptomatic patients from the Southern Italy who underwent transrectal ultrasonography; 170 of them (age range: 48-93 years; median: 70 years) were at risk and underwent transrectal biopsy.
  
  
  RESULTS
  Adenomatous hyperplasia was detected in 105 patients (62%), PC in 51 (30%), prostate intraepithelial neoplasia (PIN) in 5 (3%) and inflammatory disease in 5 (3%). The median age of patients with PC was 73.5 and tumors were generally well to moderately differentiated (76%, Gleason score < or =7). Prostate cancer (or PIN) was more frequent in patients over 70 (p<0.0001). The Gleason score also increased with age: >7 in 92% and 8% of patients aged >70 and < or =70, respectively (p<0.05).
  
  
  CONCLUSIONS
  On the basis of our results organized or opportunistic PC screening of elderly men does not appear justified because: invasive carcinoma is detected in less than 1/3 of symptomatic "healthy" men; patients became symptomatic when their life expectancy is often less than 10 years; and PC is more frequent and more aggressive after 70 years.
authors.affiliation: Servizio di Radiologia, Clinica Stabia, Italy.
authors.forename: Gennaro Maria
authors.initials: GM
authors.lastname: Picone
authors.forename: Claudia
authors.initials: C
authors.lastname: Pizzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Quartuccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scognamiglio
authors.forename: Libuse
authors.initials: L
authors.lastname: Tauchmanova
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Maio
authors.forename: Pierceleste
authors.initials: P
authors.lastname: Cifarelli
authors.forename: Alma
authors.initials: A
authors.lastname: Contegiacomo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000453:epidemiology*; D019048:Prostatic Intraepithelial Neoplasia / Q000175:diagnosis / Q000453:epidemiology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D017430:Prostate-Specific Antigen