Local screening program for prostate cancer

OBJECTIVE: By massive screening of men between 50 and 75 years of age, to find those of them that are in the early stage of the carcinoma of the prostate and evaluate the usefulness of applying this method nationwide. PATIENTS AND METHODS: 183 male Pleven citizens between 50 and 75 years of age underwent clinical examination, digital rectal examination (DRE) and serum prostate-specific antigen (PSA) determination. Those with suspicious DRE or PSA > 4 ng/ml underwent further examinations: transrectal ultrasonography (TRUS) and biopsy. The sensitivity and specificity of these tests were determined. RESULTS: The mean age of the patients was 63.66 years. Six of them (3.28%) had suspicious DRE while PSA was > 4 ng/ml in 10 (5.46%) patients. Biopsy proved cancer in 2 (1.09%) patients. We needed 6 biopsies to prove one cancer. PSA had the highest sensitivity (100%), while DRE had the highest specificity (97.8%). CONCLUSION: Because of its high sensitivity, PSA could be used for massive screening of the carcinoma of the prostate. However, the low percent (1.09%) of the new-found patients with cancer and the relatively high price of the investigation leave this question open for the time being.