Incidence and pathological characteristics of prostate cancer in Italy: a contribution to the screening debate.
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.
Picone
Gennaro Maria
GM
Servizio di Radiologia, Clinica Stabia, Italy.
Pizzi
Claudia
C
Quartuccio
Antonio
A
Scognamiglio
Giuseppe
G
Tauchmanova
Libuse
L
Di Maio
Massimo
M
Cifarelli
Pierceleste
P
Contegiacomo
Alma
A
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*
D017430:Prostate-Specific Antigen