title: Prevalence of prostate cancer on autopsy: cross-sectional study on unscreened Caucasian and Asian men.
abstract: BACKGROUND
  Substantial geographical differences in prostate cancer (PCa) incidence and mortality exist, being lower among Asian (ASI) men compared with Caucasian (CAU) men. We prospectively compared PCa prevalence in CAU and ASI men from specific populations with low penetrance of prostate-specific antigen screening.
  
  
  METHODS
  Prostate glands were prospectively obtained during autopsy from men who died from causes other than PCa in Moscow, Russia (CAU), and Tokyo, Japan (ASI). Prostates were removed en-block and analyzed in toto. We compared across the 2 populations PCa prevalence, number and Gleason score (GS) of tumour foci, pathological stage, spatial location, and tumor volume using χ(2), Mann-Whitney-Wilcoxon tests, and multiple logistic regression. All statistical tests were two-sided.
  
  
  RESULTS
  Three hundred twenty prostates were collected, 220 from CAU men and 100 from ASI mean. The mean age was 62.5 in CAU men and 68.5 years in ASI men (P < .001). PCa prevalences of 37.3% in CAU men and 35.0% in ASI men were observed (P = .70). Average tumor volume was 0.303cm(3). In men aged greater than 60 years, PCa was observed in more than 40% of prostates, reaching nearly 60% in men aged greater than 80 years. GS 7 or greater cancers accounted for 23.1% and 51.4% of all PCa in CAU and ASI men, respectively, (P = .003). When adjusted for age and prostate weight, ASI men still had a greater probability of having GS 7 or greater PCa (P = .03).
  
  
  CONCLUSIONS
  PCa is found on autopsy in a similar proportion of Russian and Japanese men. More than 50% of cancers in ASI and nearly 25% of cancers in CAU men have a GS of 7 or greater. Our results suggest that the definition of clinically insignificant PCa might be worth re-examining.
authors.affiliation: Department of Surgery, Division of Urology, University of Toronto, Mount Sinai Hospital, Toronto, ON, M5T 3L9, Canada. azlotta@mtsinai.on.ca
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Zlotta
authors.forename: Shin
authors.initials: S
authors.lastname: Egawa
authors.forename: Dmitry
authors.initials: D
authors.lastname: Pushkar
authors.forename: Alexander
authors.initials: A
authors.lastname: Govorov
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kimura
authors.forename: Masahito
authors.initials: M
authors.lastname: Kido
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Cynthia
authors.initials: C
authors.lastname: Kuk
authors.forename: Marta
authors.initials: M
authors.lastname: Kovylina
authors.forename: Najla
authors.initials: N
authors.lastname: Aldaoud
authors.forename: Neil
authors.initials: N
authors.lastname: Fleshner
authors.forename: Antonio
authors.initials: A
authors.lastname: Finelli
authors.forename: Laurence
authors.initials: L
authors.lastname: Klotz
authors.forename: Jenna
authors.initials: J
authors.lastname: Sykes
authors.forename: Gina
authors.initials: G
authors.lastname: Lockwood
authors.forename: Theodorus H
authors.initials: TH
authors.lastname: van der Kwast
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000097:blood; D003430:Cross-Sectional Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D015995:Prevalence; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D012426:Russia / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen