title: Screening for prostate cancer using prostate-specific antigen testing in Japanese men on hemodialysis.
abstract: OBJECTIVE
  The objectives of this study were to evaluate the usefulness of serum prostate-specific antigen (PSA) screening in detecting prostate cancer in Japanese men on hemodialysis, and to analyze features of prostate cancer detected in these patients.
  
  
  METHODS
  This study included 115 male hemodialysis patients aged > 55 years who agreed to the measurement of serum PSA value (group A) and 7529 men aged > 55 years participating in a PSA mass screening test in Kobe City (group B) between April 2005 and March 2006. Prostate biopsy was recommended in men with serum PSA > 4.0 ng/ml in both groups. Seventy-eight patients with normal renal function aged > 55 years diagnosed as having prostate cancer during the same time period as groups A and B were also included as a comparison group (group C).
  
  
  RESULTS
  There was no significant difference in the distribution of serum PSA values between groups A and B. Prostate biopsy was performed in 8 and 205 men in groups A and B, respectively, and prostate cancer was detected in 5 and 68 in groups A and B, respectively; that is, there was no significant difference in the rate of positive prostate biopsy between these two groups (group A, 62.5%; group B, 33.2%), while the cancer detection rate in group A (4.3%) was significantly greater than that in group B (0.90%). In addition, there was no evident metastasis in five patients on hemodialysis who were diagnosed as having prostate cancer, and their serum PSA, clinical T stage and biopsy Gleason score were similar to those in group C. However, the percent of positive biopsy cores in these five was significantly greater than that in group C. All five were treated by maximal androgen blockade therapy, and all are currently alive without emergence of hormone-refractory diseases.
  
  
  CONCLUSIONS
  These findings indicate that hemodialysis patients may have an increased risk of prostate cancer, and that prostate cancer detected in such patients tends to be relatively advanced. Therefore, it would be recommended for hemodialysis patients to undergo PSA testing to screen for prostate cancer.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kurahashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Masashi
authors.initials: M
authors.lastname: Shinozaki
authors.forename: Nobutoshi
authors.initials: N
authors.lastname: Oka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D006435:Renal Dialysis
chemical_list: D017430:Prostate-Specific Antigen