Clinical And Pathological Characteristics Of Screen-detected Versus Clinically Diagnosed Prostate Cancer:A Single Center Experience

Objective:To analyze and compare the demographic and clinical data of prostate cancer patients who were clinically diagnosed or screened by Prostate-specific antigen(PSA)examination,so as to assess the impact of PSA screening on prostate cancer diagnosis.Providing reference for the development of domestic prostate cancer screening strategy.Methods:From 2016.02 to 2017.01,28162 males aged? 40 years participated in the screening of prostate cancer in our center.Among them,participants with tPSA>4.0ng/ml were required further examinations including PSA reexamination,DRE and imaging examination.Transrectal prostate biopsy were recommended if they were suspected of prostate cancer.Those who underwent biopsy and were identified as prostate cancer pathologically were regarded as screening group.At the same time,outpatients with prostate cancer-related symptoms would undergo transrectal prostate biopsy as well if they were suspected having prostate cancer by further test,the positive cases were identified as clinical group.Evaluate and analyze the clinical and pathological features of clinical group and screening group.Results: No prostate cancer <46 years old were found in either group.The age(P=0.668)and prostate volume(P=0.437)showed no difference between two group while the PSA level and prostate biopsy positive rate in the screening group were significantly lower than those in the clinical group(P <0.01),and the Gleason score of the screening group was lower than that in the clinical group(P=0.055,border P value).Compared with the clinical group,the screening group had earlier clinical stage(P<0.01),75% were localized prostate cancer and no metastatic prostate cancer.However,patients in clinical group were mostly locally advanced and metastatic prostate cancer(68.1%).Conclusions: The PSA screening project carried out in our hospital is of great significance to the early diagnosis of prostate cancer,and the detected prostate cancer are all clinically significant disease(medium and high risk).Additionally,PSA screening is not recommended for males <46 years old or >80 years old.