title: [Clinical value of prostate specific antigen screening in early detection of prostate cancer].
abstract: OBJECTIVE
  To evaluate the clinical significance of prostate-specific antigen (PSA) screening in early detection of prostate cancer in Chinese men.
  
  
  METHODS
  PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were > or = 50 years old. Prostate biopsy was recommended for those with a serum PSA level > or = 4.0 ng/ml. The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.
  
  
  RESULTS
  Of the 8562 asymptomatic men, 719 had PSA levels > or = 4.0 ng/ml and biopsy was performed in 295 of them. Fifty-eight prostate cancers were detected. The biopsy rate was 41.0% and positive detection rate was 19.7%. The overall age distribution in the screening group and the clinical groups was not significantly different (P = 0.176). However, 41.4% (24/58) of the patients in screening group were > 75 years old, and significantly more than that in the clinical group (25.6%, P = 0.0491). The proportion of the patients with PSA levels > or = 20 ng/ml in the screening group was significantly less than that in the patients of the clinical group (44.8% vs. 75.6%, P = 0.0002). Whether in the patients whose age was > 75 years old (P < 0.05) or < or = 75 years old (P = 0.0002), the patients in the screening group had significantly lower Gleason scores < 7 (60.3% vs. 34.1%, P = 0.002), more T1 or T2 tumor (87.9% vs. 26.8%, P < 0.0001) and more chance to receive radical prostatectomy (50.0% vs. 18.3%, P < 0.0001) than the patients in the clinical group did. However, the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups (P > 0.05).
  
  
  CONCLUSIONS
  Prostate-specific antigen (PSA) screening is useful for early detection of prostate cancer in Chinese men aged > or = 50 years. The patients detected by PSA screening usually show a lower PSA level, Gleason scores and early clinical stage disease, and have more chance for radical prostatectomy than the clinically diagnosed patients.
authors.affiliation: Department of Urological Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing, China. hsb@njmu.edu.cn
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Hua
authors.forename: Di
authors.initials: D
authors.lastname: Qiao
authors.forename: Ning-hong
authors.initials: NH
authors.lastname: Song
authors.forename: Ning-han
authors.initials: NH
authors.lastname: Feng
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Jie-xiu
authors.initials: JX
authors.lastname: Zhang
authors.forename: Jian-gang
authors.initials: JG
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Yuan-geng
authors.initials: YG
authors.lastname: Sui
authors.forename: Hong-fei
authors.initials: HF
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D017430:Prostate-Specific Antigen