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Prostate biopsy in Western Australia 1998-2004
B A O'Brien1, A L Brown, T Shannon
1Tissugen Pty Ltd, Perth, Western Australia.
Prostate Cancer and Prostatic Diseases
|March 31, 2010
Summary
Prostate cancer diagnosis in Western Australia showed higher detection rates and higher-grade tumors compared to US screening trials. This suggests potentially more conservative urological practices led to underdiagnosis.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Prostate cancer diagnosis relies on PSA testing and biopsy.
- Variations in diagnostic practices can impact cancer detection rates.
- Understanding regional differences in urological practice is crucial for accurate diagnosis.
Purpose of the Study:
- To review prostate cancer diagnosis in Western Australia (WA) from 1998-2004.
- To compare WA diagnostic rates with US screening data (Prostate, Lung, Colorectal and Ovarian - PLCO).
- To inform decision-making regarding PSA testing and prostate biopsy.
Main Methods:
- Retrospective review of 5145 men undergoing initial prostate biopsy in WA.
- Analysis of cancer detection rates and histological grade (Gleason sum).
- Comparison of WA data with baseline data from the US PLCO cancer screening trial.
Main Results:
- Cancer detection rates were 59% for initial and 32% for repeat biopsies.
- High-grade cancer (Gleason sum ≥7) was detected in 69% of initial and 38% of repeat biopsies.
- WA diagnosis rates and high-grade tumor detection were 1.6-fold higher than in the US PLCO trial.
Conclusions:
- Urological practice in WA (1998-2004) was more conservative than in the US, potentially leading to prostate cancer underdiagnosis.
- Higher detection rates and histological grade suggest a more cautious diagnostic approach.
- Findings may be relevant for countries with differing urological practices compared to the US.
