Practice patterns of Korean urologists for screening and managing prostate cancer according to PSA level.
OBJECTIVE
There are still debates on the benefit of mass screening for prostate cancer (PCA) by prostate specific antigen (PSA) testing, and on systemized surveillance protocols according to PSA level. Furthermore, there is a paucity of literature on current practice patterns according to PSA level in the Korean urologic field. Here, we report the results of a nationwide, multicenter, retrospective chart-review study.


METHODS
Overall 2122 Korean men (>40 years old, PSA >2.5 ng/mL) were included in our study (from 122 centers, in 2008). The primary endpoint was to analyze the rate of prostate biopsy according to PSA level. Secondary aims were to analyze the detection rate of PCA, the clinical features of patients, and the status of surveillance for PCA according to PSA level.


RESULTS
The rate of prostate biopsy was 7.1%, 26.3%, 54.2%, and 64.3% according to PSA levels of 2.5-3.0, 3.0-4.0, 4.0-10.0, and >10.0 ng/mL, respectively, and the PCA detection rate was 16.0%, 22.2%, 20.2%, and 59.6%, respectively. At a PSA level >4.0 ng/mL, we found a lower incidence of prostate biopsy in local clinics than in general hospitals (21.6% vs. 66.2%, respectively). A significant proportion (16.6%) of patients exhibited high Gleason scores (≥8) even in the group with low PSA values (2.5-4.0 ng/mL).


CONCLUSIONS
We believe that the results from this nationwide study might provide an important database for the establishment of practical guidelines for the screening and management of PCA in Korean populations.
Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, Korea. chung646@yuhs.ac
Mun Su
MS
Chung
Seung Hwan
SH
Lee
Dong Hoon
DH
Lee
Se Joong
SJ
Kim
Choung Soo
CS
Kim
Kyu Sung
KS
Lee
Jae Il
JI
Jung
Sae Woong
SW
Kim
Yil Seob
YS
Lee
Byung Ha
BH
Chung
D000368:Aged; D044466:Asian People; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D012189:Retrospective Studies; D014572:Urology
D017430:Prostate-Specific Antigen