1926 LOWER URINARY TRACT SYMPTOMS (LUTS) ARE RISK FACTORS FOR ADVANCED PROSTATE CANCER IN JAPANESE ELDERLY MEN

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening III1 Apr 20121926 LOWER URINARY TRACT SYMPTOMS (LUTS) ARE RISK FACTORS FOR ADVANCED PROSTATE CANCER IN JAPANESE ELDERLY MEN Munekado Kojima, Yasufumi Yada, and Yosimasa Hayase Munekado KojimaMunekado Kojima Nagoya, Japan More articles by this author , Yasufumi YadaYasufumi Yada Nagoya, Japan More articles by this author , and Yosimasa HayaseYosimasa Hayase Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2083AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In Japan, screening for prostate cancer using PSA has not been established yet, and prostate cancer is detected frequently among symptomatic men. In particular, lower urinary tract symptoms (LUTS) are considered to be one of risk factors of prostate cancer. However, the prevalence of prostate cancer among Japanese elderly men presenting with LUTS is still remained unknown. The present study was conducted to characterize the prevalence and the nature of prostate cancer in Japanese elderly male patients presenting with LUTS. METHODS A total of 2127 patients underwent systematic prostate biopsy due to abnormal DRE and/or TRUS and/or serum PSA levels in Nagoya Urology Hospital. Among them, 833 (39%) patients (LUTS group) presenting with LUTS underwent prostate biopsy as a result of urological examinations including PSA measurements. Biopsy results and clinical data of LUTS group were compared with those of 429 (20%) patients (PSA screening group) who were asymptomatic and underwent prostate biopsy based on PSA screening results. RESULTS Between LUTS and PSA screening groups, there were statistically significant differences noted in age (70 vs 66 years, p<0.0001), serum PSA levels (7.8 vs 6.7 ng/mL, p<0.0001) and prostate volume (32 vs 27 mL, p<0.0001). In addition, abnormal findings on DRE (28% vs 13%, p<0.0001) and TRUS (35% vs 20%, p<0.0001) were recognized more frequently in LUTS than PSA screening groups. No significant difference was, however, recognized in positive biopsy rate between these 2 groups (41% vs 45%). More importantly, metastatic prostate cancers were recognized in 18% of LUTS group, compared to only 3% of PSA screening group (p<0.0001). CONCLUSIONS The present study demonstrated that there was no difference in the detection rate of prostate cancer on systematic biopsy between LUTS and PSA screening groups. However, the frequency of metastatic disease was statistically significantly higher in LUTS group (18%) than PSA screening group (3%). Accordingly, LUTS are considered to be significant risk factors for advanced prostate cancer in Japanese elderly men. These results suggest strongly that the screening of prostate cancer using PSA in asymptomatic men has to be promoted to reduce prostate cancer death in Japan. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e777 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Munekado Kojima Nagoya, Japan More articles by this author Yasufumi Yada Nagoya, Japan More articles by this author Yosimasa Hayase Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...