[Detection of early prostatic cancer in mass screening program]

Area of Science:

• Urology
• Oncology
• Diagnostic Imaging

Background:

• Prostate cancer screening is crucial for early detection and improved patient outcomes.
• Mass screening programs aim to identify diseases in asymptomatic populations.
• Transrectal ultrasonography (TRS) is a key imaging modality in prostate diagnostics.

Purpose of the Study:

• To evaluate the effectiveness of a mass screening program for prostatic diseases.
• To assess the diagnostic accuracy of transrectal ultrasonography (TRS), palpation, and tumor markers in mass screening.
• To determine the detection rate and stage distribution of prostate cancer in a screened population.

Main Methods:

• A mass screening program conducted from 1975 to 1988 involving 6,674 examinees.
• Utilized transrectal ultrasonography (TRS) as the primary screening tool.
• Evaluated diagnostic accuracy of TRS, digital rectal examination (palpation), and tumor markers, including Prostate-Specific Antigen (PSA).

Main Results:

• Detected 42 cases of prostate cancer (0.6% detection rate) among 6,674 examinees.
• Diagnosed 24 cases (57.1%) as early-stage prostate cancer (Stage A1, Stage B).
• TRS demonstrated a low false-negative rate, while palpation showed a low false-positive rate. PSA was effective for early detection but faced challenges distinguishing from Benign Prostatic Hyperplasia (BPH) due to high false positives.

Conclusions:

• Mass screening using TRS is effective for detecting prostate cancer, particularly in early stages.
• TRS offers high sensitivity for prostate cancer detection in screening settings.
• While PSA aids early detection, further refinement is needed to differentiate prostate cancer from BPH effectively.