title: Evaluation of prostatic cancer prevalence in patients with prostatic-specific antigen between 4 and 10 and normal digital rectal examination.
abstract: BACKGROUND
  Prostate cancer is one of the most common male cancers. The prevalence of prostate cancer is different due to genetic and environmental factors. Diagnosis of prostate cancer is by biopsy due to prostate-specific antigen (PSA) and Digital Rectal Examination (DRE). Controversy about decision making for prostate biopsy in PSA between 4 and 10 and normal DRE, is one of the problems in this time. In this study we evaluated the prevalence of prostate cancer in males with PSA between 4 and 10 and normal DRE. We also evaluated the PSA density and percent of free PSA in patients with prostate cancer.
  
  
  METHODS
  A total of 121 males with PSA between 4 and 10 and normal DRE, were evaluated. Then, transrectal ultrasonography (TRUS) andprostate biopsy from 12 points of peripheral zone, was done. These data were analyzed by Chi-square, t-test and ANOVA and Roc curve.
  
  
  RESULTS
  In this study, the prevalence of prostate cancer in PSA between 4 and 10 and normal DRE, was evaluated, 29.8%. With use of Roc curve, PSA density cutoff point was calculated 0.12 and percent of free PSA cutoff point, was calculated, 18%.
  
  
  CONCLUSIONS
  In males with PSA between 4 and 10 and normal DRE, PSA density smaller than 0.12-0.15, and percent of free PSA greater than 18%, the prevalence of prostate cancer is very few and we can safely ignore the TRUS and prostate biopsy in these males and eliminate its costs and side effects.
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Tadayon
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Arezegar
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Mohammad Hatef
authors.initials: MH
authors.lastname: Khorrami
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Hashemi Juzdani
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Amir Abbas
authors.initials: AA
authors.lastname: Shahdoost
authors.affiliation: Department of Urology, Isfahan University of Medical Science, Isfahan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mellat
keywords: Benign prostatic hyperplasia; digital rectal examination; percentage of free prostate-specific antigen; prostate cancer; prostate-specific antigen; prostate-specific antigen density