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Incidence of insignificant prostate cancer using free/total PSA: results of a case-finding protocol on 14 453 patients

Prostate Cancer and Prostatic Diseases volume 13, pages 316–319 (2010)Cite this article

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Abstract

To evaluate prostate cancer (PCa) detection and incidence of pathologically insignificant PCa (pIPCa) tumour using percent-free PSA (%f-PSA) in patients with total PSA ⩽10 ng ml−1. From February 2002 to October 2009, 14 453 patients (median 60.5 years) were enrolled in a case-finding protocol for the early diagnosis of PCa. Indications to biopsy were suspicious digital rectal examination; PSA >10 ng ml−1; PSA⩽2.5 ng ml−1, included between 2.6–4 and 4.1–10 ng ml−1 with %f-PSA <15, <20 and <25%, respectively. A median of 18 and 26 cores in case of primary and repeated biopsy were determined; 2123 men underwent prostate biopsy, of whom 1589 (74.8%) had a PSA ⩽10 ng ml−1. A PCa was found in 777 (36.6%) and in 35 (23.3%) patients at primary and repeated biopsy: 459 and 26 men had PSA ⩽10 ng ml−1 and 419 and 26 patients underwent surgery, respectively, 244 (58.3%) and 18 (69.2%) had an organ-confined PCa with a pIPCa incidence equal to 1.4 and 7.7%, respectively. Cancer detection rate of 28.8% in patients with PSA ⩽10 ng ml−1 associated with a low incidence of pIPCa should induce to introduce %f-PSA in screening programmes to reduce the risk of overdiagnosis.

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  1. Urology Unit, Cannizzaro Hospital, Catania, Italy

    P Pepe & F Aragona

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Correspondence to P Pepe.

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Pepe, P., Aragona, F. Incidence of insignificant prostate cancer using free/total PSA: results of a case-finding protocol on 14 453 patients. Prostate Cancer Prostatic Dis 13, 316–319 (2010). https://doi.org/10.1038/pcan.2010.29

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