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Serendipity in detecting disease in low prostate-specific antigen ranges
1Department of Pathology, Josephine Nefkens Institute, Erasmus University Rotterdam, The Netherlands. vis@path.azr.nl
BJU International
|March 2, 2002
Summary
Many prostate cancers are found by chance during screening in men with low PSA levels. This reliance on serendipity is disadvantageous for effective prostate cancer detection.
Area of Science:
- Urology
- Oncology
- Medical Diagnostics
Background:
- Prostate cancer screening often involves digital rectal examination (DRE) and transrectal ultrasonography (TRUS).
- Serendipitous detection of prostate cancer occurs when it's found incidentally during evaluation for other reasons.
Purpose of the Study:
- To quantify the rate of prostate cancer detection by serendipity.
- To evaluate the role of DRE and TRUS in initial prostate cancer screening for men with low prostate-specific antigen (PSA) levels (0.0-3.9 ng/mL).
Main Methods:
- A population-based screening study involving 117 participants diagnosed with prostate cancer.
- Serendipity was defined by specific criteria including cancer location, biopsy results, and tumor volume (< 0.5 mL).
Main Results:
- Between 27-63% of prostate cancers in men with low PSA were detected serendipitously.
- The rate of serendipitous detection was inversely related to the serum PSA level.
Conclusions:
- A significant proportion of prostate cancers in men with low PSA are detected by chance.
- Relying on serendipity is disadvantageous, suggesting DRE and TRUS may have limited utility as primary screening tools due to poor performance and variability.