Screening for prostate cancer in Romania

In Romania, more than 95% of patients present with advanced stage prostate cancer at the time of diagnosis. Our purpose was to detect early prostate cancer in the Romanian city of Oradea, with a screening based on digital rectal examination and fine needle aspiration biopsy. We performed digital rectal examinations on 701 men, between 50 to 80 years of age. Four men with a history of prostate cancer were excluded from the study. Transrectal fine-needle aspiration biopsies were done in 15 men who presented with suspicious findings at the digital rectal examination. Prostate cancer was cytologically proven in eleven men. Nine of these were low- to intermediate grade (GI-II) and clinically localized (T2). Two patients had clinical stage T3 tumors. The prostate cancer detection rate in the screened population was 1.6% (11/697). Currently, eight men have undergone total retropubic prostatectomy. One patient presented with pelvic lymph node metastases and, after a staging lymphadenectomy, only a bilateral orchiectomy was performed. This first Romanian mass screening study for prostate cancer revealed a great interest in early cancer detection among the general public. Continued effort to make asymptomatic men aware of the disease may ultimately lead to an overall stage reduction at the time of diagnosis in Romania.