Prostate cancer screening in a Saudi population: an explanatory trial study

The aim of this study is to explore the actual situation of prostate cancer in a cohort of healthy population in Saudi Arabia and to show the feasibility of screening for this disease using the internationally agreed criteria. This study was conducted in the city of Riyadh, in the outpatient clinics of four different health facilities. All men presented to the outpatient clinics during the period of study, from January 2008 to December 2008, were invited to participate in the study, in which they were subjected to PSA blood testing and digital rectal examination (DRE). When either test was abnormal, transrectal ultrasound and multiple prostatic biopsies were performed for confirmation of the results. A total of 2100 healthy males who met the inclusion criteria of the study were evaluated. The highest percentage of men with PSA>/=4 ng ml(-1) was in the age group 61-70, 51-60 years (42.7 and 31.8%, respectively). The number of subjects with an elevated PSA only was 172 (8.1%). Those having both elevated PSA and an abnormal DRE were 51 (2.4%). The total number referred to biopsy was 223. Fifty two subjects had a positive diagnosis of prostatic adenocarcinoma, which compromised 2.5% of the cohort studied. The cancer in 27 (52%) persons was organ confined, whereas in 14 (26.9%), it was metastatic. The prevalence rate of prostate cancer detected by screening was higher than expected and the disease was advanced. Larger community-based larger studies are highly warranted specially among high-risk groups.