A 6‐year analysis of the clinicopathological profile of patients with prostate cancer at the University Hospital of the West Indies, Jamaica

Abstract

OBJECTIVE To document the clinicopathological characteristics of prostate cancer in a public hospital-based population in Jamaica, over a 6-year period, and examine any trends in these characteristics over time, as prostate cancer is the leading cause of cancer in Jamaican men, but there are few published reports documenting the clinicopathological profile of this disease in the Jamaican population. PATIENTS AND METHODS All patients consecutively diagnosed with prostate cancer by transrectal ultrasonography-guided biopsy at the University Hospital of the West Indies, from January 2000 to December 2005, were identified at time of diagnosis, and relevant clinical and pathological data collected from the accompanying histopathology request forms. RESULTS There were 529 cases of prostate cancer diagnosed over the 6 years. The mean (sd) age was 70.66 (8.74) years, with 137 patients aged 70-74 years. A serum prostate-specific antigen (PSA) level was obtained for 490 (92.6%) patients. Of these, an accurate PSA value was available for 456 (86.2%) patients and a 'minimum level' recorded for the remaining 34, all of whom had a PSA level of >100 ng/mL. Of the patients with available PSA information, only 91 (18.5%) had a level of < or =10.0 ng/mL. By contrast, 155 (31.6%) patients had levels of >100 ng/mL. The median (range, interquartile range) serum PSA level for those patients with accurate values was 30.7 (1-14 260, 11.7-109) ng/mL. Histologically, moderately and poorly differentiated cancers accounted for 198 (37.5%) and 160 (30.2%) cases, respectively. Correlation of the variables under investigation confirmed that there was a statistically significant positive and moderate correlation between serum PSA level and Gleason score (Spearman r 0.49; P < 0.001). Statistical analysis of all other variables, including the number of cases of prostate cancer diagnosed annually, showed no significant differences. CONCLUSION Compared with many countries, including some in the Caribbean, prostate cancer in Jamaican men is diagnosed when they are older and these patients have significantly higher PSA levels at diagnosis, suggesting more advanced disease. Despite increasing public awareness of prostate cancer, it appears that there has been no significant change in the profile of patients with prostate cancer, at the time of diagnosis, over the last 6 years, findings consistent with the absence of an organized screening programme for prostate cancer in Jamaica.