title: Characteristics of Prostate Cancer by Opportunistic Screening in Korean Men with a Prostate-Specific Antigen Level Less Than 4.0 ng per Milliliter.
abstract: Background/Aims/Objectives: We studied the detection rate of prostate cancer (PCa) among Korean men with a prostate-specific antigen (PSA) level of less than 4.0 ng/mL.
  
  
  METHODS
  A total of 1,680 men with PSA ≤4 ng/mL had a prostate biopsy from January 2004 to December 2014. The differences in clinical factors were analyzed and their independent predictive implications were evaluated.
  
  
  RESULTS
  PCa was diagnosed in 331 (19.6%) and 99 of these 331 cancers (14.9%) had a Gleason score of 7 or higher. The detection rate of PCa increased from 6.67% (≤0.5 ng/mL) to 20.36% (3.01-3.9 ng/mL). There were significant differences in age 65.7 vs. 62.1 years, prostate volume 33.4 vs. 38.2 g, PSA density 0.10 vs. 0.08 ng/mL/mL between men with and without PCa. On multivariable analysis, age and prostate volume were the best independent discriminative parameters. When comparing PCa patients with a Gleason score less than 6 to those with a 7 or higher, patients with a Gleason score 7 or higher were older (67.2 vs. 64.8 years).
  
  
  CONCLUSIONS
  Even when the PSA level is less than 4 ng/mL, PCas, including high-grade cancers, were detected in a significant number of men. In this group, patients with PCa were older and had a smaller prostate volume and high-grade cancers were detected more frequently in older cancer patients.
authors.affiliation: Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Choi
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Bae
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Du Geon
authors.initials: DG
authors.lastname: Moon
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Park
mesh_terms: D000367:Age Factors; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D055088:Early Detection of Cancer / Q000379:methods*; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D016017:Odds Ratio; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Biopsy; Prostate cancer; Prostate-specific antigen