Endocrine Abstracts

Introduction: It is known from world experience that the common screening method for diagnosing prostate cancer is the level and density of prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing have not been evaluated in Uzbek clinical practice. There are no proper guidelines to investigate suspected prostate cancer in Uzbekistan.

Methods: A total of 101 men were included in our investigation who were examined in the Republican specialized center of urology. All the patients underwent a complete examination, including laboratory(PSA level), ultrasound, transrectal ultrasonography, and prostate biopsy The patients were divided into subgroups by PSA level and PSA density, PSA density was calculated as total PSA (ng/ml) divided by prostate volume (ml).

Results: In patients with lower PSA levels less than 4 ng/ml detected benign processes compared to patients who had higher values of more than 50 nglml. Only two cases that had less than 4 ng/mg were suspicion of malignancy. When the PSA value was more than 100 ng/ml, almost all the cases were malignant. Between PSA values of 4-100 ng/ml, the probability of cancer diagnosis was 54% (54 cancers out of 101 in this range). Limitation of PSA testing has the risk of overdiagnosis and the resultant negative biopsies owing to poor specificity. Whereas the limit for cancer diagnosis remains 4 ng/ml from our study, most of the patients can be assured of benign lesion below this level, and thus morbidity associated with the biopsy can be prevented. PSA density was associated with the risk of finding PCa both with and without adjusting for the additional clinical information age, family history, previous biopsies, total PSA, and free/total PSA.

Conclusion: The PSA level plays important role in diagnosing prostate cancer and can reassure and educate the patients towards the diagnosis of cancer of the prostate in Uzbekistan. It is recommended prostatic biopsy if the level is below 4 ng/ml and a level of 100 ng/ml can be very unfavorable for the patients. Regarding the PSA-density might inform biopsy decisions, and spare some men from the morbidity associated with a prostate biopsy and diagnosis of low-grade prostate cancer.