title: Efficacy of Repeated Transrectal Prostate Biopsy in Men Younger Than 50 Years With an Elevated Prostate-Specific Antigen Concentration (>3.0 ng/mL): Risks and Benefits Based on Biopsy Results and Follow-up Status.
abstract: OBJECTIVE
  Prostate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL).
  
  
  METHODS
  During the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up.
  
  
  RESULTS
  The mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data.
  
  
  CONCLUSIONS
  All patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL).
authors.affiliation: Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Ho Gyun
authors.initials: HG
authors.lastname: Park
authors.affiliation: Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Oh Seok
authors.initials: OS
authors.lastname: Ko
authors.affiliation: Department of Urology, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Young Gon
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Department of Urology, Chonbuk National University Medical School, Jeonju, Korea. ; Institute for Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea. ; Biomedical Research Institute, Chonbuk National University Medical School, Jeonju, Korea. ; Clinical Trial Center of Medical Devices, Chonbuk National University Medical School, Jeonju, Korea.
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Park
keywords: Biopsy; Follow-up studies; Prostate; Prostate-specific antigen; Young adult
references.citation: JAMA. 1993 Aug 18;270(7):860-4
references.pmid: 7688054
references.citation: Am J Surg Pathol. 1999 Aug;23(8):932-6
references.pmid: 10435563
references.citation: World J Urol. 2012 Apr;30(2):131-5
references.pmid: 22101902
references.citation: BJU Int. 2007 Apr;99(4):753-7
references.pmid: 17244286
references.citation: J Urol. 1994 Nov;152(5 Pt 2):1732-6
references.pmid: 7523720
references.citation: N Engl J Med. 2009 Mar 26;360(13):1351-4
references.pmid: 19297564
references.citation: Eur Urol. 2012 Jan;61(1):1-7
references.pmid: 21862205
references.citation: Urology. 2005 Jul;66(1):108-13
references.pmid: 15992911
references.citation: BJU Int. 2004 Mar;93 Suppl 1:10-5
references.pmid: 15009080
references.citation: Korean J Urol. 2010 Jan;51(1):21-4
references.pmid: 20414405
references.citation: Urology. 2002 Sep;60(3):475-9
references.pmid: 12350489
references.citation: Korean J Urol. 2011 Jul;52(7):457-60
references.pmid: 21860765
references.citation: Urology. 1999 Jun;53(6):1179-83
references.pmid: 10367849
references.citation: Carcinogenesis. 2005 Jul;26(7):1170-81
references.pmid: 15498784
references.citation: Urol Clin North Am. 1997 May;24(2):293-7
references.pmid: 9126226
references.citation: N Engl J Med. 2003 Jul 24;349(4):366-81
references.pmid: 12878745
references.citation: Urology. 2005 Apr;65(4):745-9
references.pmid: 15833520
references.citation: J Nutr. 2002 Nov;132(11 Suppl):3451S-3455S
references.pmid: 12421869