Rasgos diferenciales del cáncer de próstata procedente de un programa de detección precoz frente al detectado en una consulta de urología

Abstract

ObjectiveTo compare some features of prostate cancers (PCa) detected in a screening program, versus cancers diagnosed in an outpatient clinic Material And MethodsRetrospective study of 393 patients with biopsy evidence of PCa: 93 (23,7%) from a screening campaign, and 300 (76,3%) detected in an outpatient Urology clinic. Features studied at the moment of diagnosis were age, PSA, digital rectal examination (DRE), transrectal ultrasound (TRUS) characteristics and volume stimation, PSA density (PSAD), clinical stage and Gleason score. A comparison was established between the two groups of patients taking into account the mentioned parameters ResultsA higher age, PSA and DPSA values were found among cancers detected out of the screening program. A greater probability of abnormal DRE and a more advanced clinical stage was also noted. In the screening group, 78,5% of the cancers were localized and 8,6% methastatic. In the outpatient clinic group, the proportions were 50,7% and 26%, respectively. No differences were found with respect to TRUS findings, prostate volume, or Gleason score ConclusionsCancers detected in screening programs are found in earlier stages. Nevertheless, results from long term randomized studies are necessary to verify if these data really mean that a disease-specific mortality reduction can be achieved