title: Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population?
abstract: We investigated the prostate cancer detection rates upon transrectal ultrasound (TRUS)-guided biopsy in relation to digital rectal examination (DRE) and prostate-specific antigen (PSA), and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of < 4, 4-10, 10.1-20, 20.1-50 and > 50 ng ml-1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA < 4, 4-10, 10.1-20, 20.1-50 and > 50 ng ml-1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA < 4, 4-10, 10.1-20, 20.1-50 and > 50 ng ml-1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses (P < 0.001). Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.
authors: Jeremy Yc
authors: JY
authors: Teoh
authors: Steffi Kk
authors: SK
authors: Yuen
authors: James Hl
authors: JH
authors: Tsu
authors: Charles Kw
authors: CK
authors: Wong
authors: Brian Sh
authors: BSh
authors: Ho
authors: Ada Tl
authors: AT
authors: Ng
authors: Wai-Kit
authors: WK
authors: Ma
authors: Kwan-Lun
authors: KL
authors: Ho
authors: Department of Surgery, Division of Urology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors: Ming-Kwong
authors: MK
authors: Yiu
mesh_terms: D000368:Aged; D002681:China; D051517:Digital Rectal Examination; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
references: Cancer. 1981 Sep 1;48(5):1229-32
references: 6168364
references: J Urol. 2002 Nov;168(5):1990-3
references: 12394692
references: Cancer. 1994 Sep 1;74(5):1516-8
references: 7520346
references: J Urol. 1994 Dec;152(6 Pt 1):2031-6
references: 7525994
references: J Urol. 1994 Dec;152(6 Pt 1):2037-42
references: 7525995
references: Urology. 2000 Aug 1;56(2):255-60
references: 10925089
references: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references: 19474385
references: N Engl J Med. 2004 May 27;350(22):2239-46
references: 15163773
references: Exp Med Surg. 1969;27(4):406-10
references: 4193317
references: J Urol. 1997 Sep;158(3 Pt 1):861-4
references: 9258099
references: Asian J Androl. 2005 Jun;7(2):159-63
references: 15897972
references: Jpn J Clin Oncol. 2006 Jun;36(6):376-80
references: 16735369
references: J Cancer Res Clin Oncol. 2008 Nov;134(11):1207-10
references: 18446367
references: Jpn J Clin Oncol. 2008 Dec;38(12):844-8
references: 18941125
references: J Urol. 1994 May;151(5):1283-90
references: 7512659