[Usefulness of screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("human dock") at Onomichi Municipal Hospital: clinical significance of the cases diagnosed as prostate cancer].
OBJECTIVE
The usefulness of the screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("Human Dock") at Onomichi Municipal Hospital was evaluated.


METHODS
From April 1997 to December 2007, serum PSA of 1,234 male (median age: 59) was measured in the medical checkup and each parameter of screening was evaluated. In addition, for the cases with prostate cancer, results of treatment and clinical significance were assessed.


RESULTS
PSA was elevated in 82 cases (6.6%), aged 42-87 (median 64), in which PSA varied 3.1-66.5 ng/ml (median 5.4). Trans-rectal biopsy was performed in 35 cases and prostate cancer was detected in 15 (42.9% of biopsied cases and 1.2% of whole group), aged 58-81 (median 70), with PSA value 4.2-66.5 ng/ml (median 10.3). Clinical stage of these cases was cT1cN0M0 in 12 and cT2aN0M0 or more in 3, Gleason score was 3 + 3 in 4 and 3 + 4 or more in 11. Initial treatment was radical prostatectomy in 12, androgen-deprivation therapy in 2 and external beam irradiation in 1. During the follow-up for 8-107 months (median 60), 14 were alive with good control and 1 was alive with relapse. Only one case was "clinically insignificant" cancer (impalpable and localized and tumor volume less than 0.5 ml and Gleason score 3 + 3 or less).


CONCLUSIONS
Most of the prostate cancers detected in the medical checkup were clinically significant, therefore, PSA screening doesn't result in overtreatment and it is meaningful to perform PSA screening in the medical checkup.
Department of Urology, Onomichi Municipal Hospital.
Tadashi
T
Oeda
Norihiro
N
Kusumi
Atsushi
A
Takamoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005500:Follow-Up Studies; D006773:Hospitals, Municipal; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009098:Multiphasic Screening; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen