Screening of prostate cancer in males with prostatism

Comparison of different screening methods including digital rectal examination (DRE) and estimation of serum prostate specific antigen (PSA) had been done for detection of cancer prostate at initial stages in 186 patients presenting with prostatism. The detection rate of raised serum PSA (> 4 ng/dl) was found significantly higher than that of abnormal DRE because it could detect cases of prostate cancer at very early stages. On the other hand using abnormal DRE alone as criteria for biopsy, large number of these cases, specially at early stages, would have remained undetected (36.9%) thereby giving false low incidence. Serum PSA was found raised in pre neoplastic conditions (73.9%) like PIN and AAH also, majority of which were missed on DRE (65.2%). Raised serum PSA was found in many benign conditions (36.7%, false positive) also, hence prostatic biopsy is advised to confirm malignancy.