A comparative analysis of prostate cancer pre-treatment characteristics stratified by age

To compare the pretreatment characteristics of prostate cancer, prostate-specific antigen (PSA), digital rectal examination (DRE) and Gleason sum score (GSS) by the American Urological Association (AUA) stratified age groups, < 55, 55-69 and ≥ 70 years old.

A retrospective analysis of 402 sequential prostate cancer patients, who had transrectal ultrasound guided 12 core prostate biopsy for either elevated PSA (over 2.5 ng/mL) or positive DRE or both during a three period, 2010 to 2012. There were 36 patients < 55 years, 226 patients 55 to 69 years and 140 patients ≥ 70 years (range 44-78 years old). This study was conceptualized after the AUA released prostate cancer screening guidelines in which men ≥ 70 were deleted from screening.

Overall, compared with patients < 70 years old, we found that in patients ≥ 70 years old: 1) 60.7% had high GSS (7-10) (p = 0.0234); 2) 39.3% had low GSS (6) (p = 0.0234); 3) 31% had PSA level ≥ 10 ng/mL (p = 0.0010) and 4) 69.1% had high GSS (7-10) in the presence of a positive DRE (p = 0.0278).

Patients ≥ 70 years old had a higher incidence of high GSS (7-10) compared to prostate cancer patients < 70 years old. Patients ≥ 70 years old who also had a positive DRE had the highest incidence of high GSS.