Prevalence Of Prostate Cancer Research Articles

Toenail arsenic species and metallome profiles associated with breast, cervical, prostate, and skin cancer prevalence in the Atlantic Partnership for Tomorrow's Health cohort.

Chronic exposure to arsenic through drinking water has been linked to several cancers. The metabolism of arsenic is thought to play a key role in arsenic-related carcinogenesis as metabolites of varying toxicity are produced and either stored in or excreted from the body. Atlantic Canada has the highest age-standardized incidence rates of all cancers in the country. This may be due to its high levels of environmental arsenic and the prevalence of unregulated private wells for water consumption. Here, we aimed to characterize the profiles of arsenic species and metallome in the toenails of four cancer groups, compare them to healthy participants (N = 338), and assess potential associations between the profiles with cancer prevalence. This study employed a case-control design. Toenail samples and questionnaire data from cases (breast, cervical, prostate, and skin cancers) and controls were sourced from the Atlantic Partnership for Tomorrow's Health (PATH) cohort study. The levels of arsenic species were measured using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) paired with High Performance Liquid Chromatography (HPLC) and total concentrations of metallome (23 metals) were determined by ICP-MS separately. Multivariate analyses were conducted to compare cases with controls within each cancer group. Arsenic speciation profiles varied by cancer type and were significantly different between cases and controls in the breast (p = 0.0330), cervical (p = 0.0228), and skin (p = 0.0228) cancer groups. In addition, the profiles of metallome (nine metals) were significantly differentiated in the prostate (p = 0.0244) and skin (p = 0.0321) cancer groups, with higher zinc concentrations among cases compared to controls. History of cancer diagnosis was associated with specific profiles of arsenic species and metallome. Our results indicate that arsenic methylation and zinc levels, as measured in toenails, may be an important biomarker for cancer prevalence. Further research is needed to use toenails as a prognostic measure of arsenic-and other metal-induced cancer.

Myocardial bridge in a patient with castration-resistant metastatic prostate cancer treated with enzalutamide.

Myocardial bridge is a morphological anomaly of the heart characterised by the presence of a myocardial segment above a coronary artery, which results in a higher risk of cardiovascular events. In patients with prostate cancer treated with androgen receptor-targeted agents, a higher risk of cardiotoxicity was observed. An 88 years old man with metastatic castration-resistant prostate cancer in treatment with enzalutamide, denosumab, and triptorelin presented to our attention complaining dyspnoea and angina pectoris. Blood examinations revealed normal Troponin I levels. Transthoracic echocardiography revealed no signs of acute myocardial ischaemia. The treadmill stress test revealed S-T tract under levelling in V4-V6 with a very slow resolution. Coronary angiography identified a myocardial bridge in the medium tract of the interventricular anterior artery. Due to these findings, ranolazine and simvastatin were started and, after multidisciplinary assessment, we decided to continue the treatment with enzalutamide. At the first follow-up visit echocardiography found out the cardiological reports stability and no therapy changes were performed. During follow-up visit cardiological revaluation showed reports stability and no therapy changes were performed. Due to the high prevalence of prostate cancer in elderly patients at high cardiovascular risk and the increasing use of androgen receptor-targeted agent, a multidisciplinary approach is highly recommended to weigh survival benefits on toxicities. This case report may support the use of androgen receptor-targeted agent in elderly patients with controlled cardiovascular diseases, a population that is often excluded from randomised trials.

Learned lessons from a US-wide outreach program to broaden enrollment to the PROMISE Registry, a prostate cancer genetic registry.

10628 Background: Updates to NCCN genetic testing recommendations and approved PARPi treatments for prostate cancer (PCa) patients (pts) have clarified the need for genetic registries to identify pts for novel treatments and understand real-world effects of targeted therapies. PROMISE (NCT04995198) is a US prospective genetic registry that has deployed an outreach program to broaden enrollment beyond the usual approach of academic medical centers as recruitment sites. PROMISE aims to create a PCa genetic registry by enrolling and screening 5,000 PCa pts via germline testing to identify 500 for long-term follow-up with germline mutations in genes of interest. Methods: The outreach program was initiated in May 2021 alongside enrollment. The program aims to supplement ongoing recruitment at 23 institutions by broadening enrollment to include populations and areas not served by academic medical centers. Direct-to-pt outreach was prioritized via partnerships with PCa advocacy organizations with groups and geographic areas with high prevalence of PCa. Online activities include webinars, interviews, podcasts, articles, partner email blasts, and newsletters. In-person activities include tabling and presentation at patient- and provider-facing conferences, and tabling at pt walks. Letters were sent introducing PROMISE through the Maryland Cancer Registry to individuals with PCa. A dedicated team including marketing, partnerships and engagement, and website SEO specialists support the program. Funding for the outreach program is provided by the study funder, Advancing Clinical Trials (ACT). Results: As of January 2023, study accrual is 54% ahead of initial projections. 2,178 have been enrolled and 219 are eligible for long-term follow-up across 48 states, with most enrollment occurring on the east and west coasts. Race/ethnicity distribution is as follows: American Indian or Alaska Native 0.4%, Asian 2.0%, Black 3.9%, Hispanic 1.8%, Native Hawaiian or Pacific Islander 0.1%, White 76.4%, unknown 0.4%, and no response provided 16.3%. Conclusions: Traditional recruitment efforts by academic medical centers, when supplemented with direct-to-pt outreach yields increased enrollment. Effective components include 1) partnerships with PCa advocacy organizations, 2) communication from PIs, Investigators, and other medical professionals via webinars and interviews with clinically relevant topics and Q&A, and 3) varied methods of outreach. While the program has led to high accrual, distribution of enrolled participants supports findings from other genetic and genomic registries indicating that increasing diversity continues to be a challenge. Moving forward, we will continue to work with outreach partners to find well-targeted, efficient ways to reach PCa patients with attention to increasing participant diversity. Clinical trial information: NCT04995198 .

Standard 12-Core Transrectal Ultrasound-Guided Prostate Biopsy, a Useful Tool in Screening for Prostate Cancer: A Prospective Study in Uyo, Akwa Ibom State, Nigeria

Introduction: Guided prostate biopsy is still relevant in confirming the diagnosis of suspected prostate cancer. Objective: This study evaluated the role of Transrectal Ultrasound (TRUS) guided biopsy along with histopathological evaluation in the detection of prostate cancer on the basis of abnormal digital rectal examination (DRE) findings and elevated prostate specific antigen levels (PSA). Participants and Methods: This prospective study was undertaken among consenting men aged 40 years and above screened for prostate cancer at the University of Uyo Teaching Hospital using targeted, stepwise protocol including DRE, PSA and standard 12-core transrectal ultrasound guided biopsy technique. Biopsy samples were sent for histopathological evaluation. Findings were documented, analyzed and presented in tables and figures. Results: Among 437 participants, abnormal DRE findings, elevated PSA level above 4.0 ng/ml and abnormal TRUS findings were 17.2%, 21.1%, and 17.3% respectively. Of 44 participants who had prostate biopsies with histopathologic assessment, benign prostatic diseases were 24 cases (54.5%), slightly outnumbering malignant prostatic diseases seen in 20 (45.5%).The prostate cancer detection and prevalence rates were 45.5% and 4.6% respectively. Prostatic adenocarcinoma (45.5%), nodular hyperplasia (45.5%), basal cell hyperplasia (6.8%) and high grade prostatic intraepithelial neoplasia (2.2%) were identified histologic subtypes. Nodular hyperplasia was commonly associated with chronic prostatitis (80.0%). A significant association between DRE findings, outline of prostate, and tumour subtype was ascertained. Conclusion: Targeted screening protocol encompassing TRUS guided 12- core biopsy is a final arbiter in the diagnosis of prostate cancer and has a fairly high prostate cancer detection rate of 45.5%.

Knowledge and Attitude of Men towards Prostate Cancer Screening. A Case Study of Men Attending Services in Imo State University Teaching Hospital Orlu

Introduction: The aim of the study is to determine the knowledge and attitude of men towards screening for prostate cancer in Imo State University Teaching Hospital, Orlu. The study assessed the level of awareness of men on the risk factors of prostate cancer. This was done so as to ascertain the extent to which prostate cancer screening methods as provided by the health workers are accepted. This helped to show the attitudes towards screening for prostate cancer. Methods: The study adopted a cross-sectional descriptive study. A total sample of 120 men receiving screening services during the period of study were used. Questionnaire was used as the method for data collection. This was both administered and self-administered. Data were analyzed using frequency tables. Results: The findings revealed that majority of the men, 84 (70%) were aware of methods of prostate cancer screening while 36 (30%) were not aware. On the knowledge about preferred types of screening measures, majority of the respondents 108 (90%) identified PSA test while 12 (10%) had no preferred prostate cancer method. The respondents’ attitude towards uptake of prostate cancer screening methods, showed a positive attitude as majority of the respondents had a mean score of 44.6 with an average mean score of 2.8. However, the knowledge on risk factors of prostate cancer showed low knowledge with a mean score of 21.6. Conclusion: The fact that a good number of the respondents had low knowledge on the risk factors for prostate cancer, presupposes the need for healthcare workers to health educate men on the risk factors of prostate cancer as well as the benefits of regular prostate cancer screening so as to increase prostate cancer screening uptake thereby, reduce the prevalence of prostate cancer.

The Prevalence of Prostate Cancer Among Young Men Below 55Years of Age in Nigeria.

Prostate cancer is the most common cancer in men. It was initially a disease of older men above the age of 55years. Of recent, there has been reports of increase in the number of young men <55years with prostate cancer (PCa). The disease in this age group has been reported to be more lethal because of aggressive characteristics and metastatic potential. Different populations have different proportions of young-onset PCa. The aim of this study was to determine the proportion of young men aged <55years with PCa in Nigeria. Data on the prevalence of young men <55years with PCa was extracted from the 2022 report of the prevalence of cancer in Nigeria from 2009 to 2016 based on the records of 15 major Cancer Registries in Nigeria. This was a publication of the Nigerian Ministry of Health and represents the most up to date data. In 4864 men diagnosed with malignancies before age 55, PCa was the second common, following liver cancer. Out of a total of 4091 cases of PCa in all age groups, 355 were diagnosed in men <55years representing 8.86%. Furthermore, the proportion of young men with the disease in the Northern part of the country was 11.72%, whereas in the South, it was 7.77%. PCa is the second most common cancer in young Nigerian men aged< 55years preceded by liver cancer. The proportion of young men with PCa was 8.86%. It is therefore important to consider PCa in young men as a different entity and develop appropriate ways to control this disease to ensure survival and good quality of life.

Prevalence and Natural History of Non-metastatic Castrate Resistant Prostate Cancer: A Population-Based Analysis.

To determine the prevalence and natural history of nmCRPC prior to the adoption of novel androgen receptor axis-targeting therapies(ARAT). This was a retrospective population-based cohort study of men with nmCRPC in Ontario, Canada between January 2007-March 2018. Patients with prostate cancer, castrate level of testosterone(<1.7nmol/L) and a PSA>2.0ng/mL with a subsequent rise>25% from the nadir, and without metastasis were included. Annual prevalence of nmCRPC was calculated. Crude time from nmCRPC to metastasis and all-cause death are presented as medians with interquartile range(IQR). Predictors of time from nmCRPC to death were compared using univariable and multivariable cox proportional hazard models. We identified 2045 patients with nmCRPC. Median age was 79(IQR:72-84). 984 patients(48.1%) received upfront hormonal therapy while 583(28.5%) received initial radiotherapy and 478(23.4%) underwent radical prostatectomy. Median time from primary treatment to nmCRPC was 6 years(IQR:3-10). The average annual prevalence of nmCRPC was 8% among men receiving ADT. Crude median time from nmCRPC to death was 37.6 months(IQR:22.1-55.4). Median time from nmCRPC to metastasis and metastasis to death was 20.0 and 8.3 months, respectively. Patients who had primary surgery experienced longer crude survival. Older patients, patients who had a higher PSA at nmCRPC, and patients with grade group 4 to 5 disease had a shorter time from nmCRPC to death. This is the largest population-level analysis of the prevalence and natural history of nmCRPC. The current study can be used as a historical cohort to compare how novel imaging modalities and ARAT impact prevalence and disease trajectory over time.

Risk analysis of metformin use in prostate cancer: a national population-based study

Introduction Various approaches are required to prevent and treat heterogeneity-based prostate cancer. Here, we analyzed the anticancer effects of metformin, which has a good toxicity profile and is inexpensive. Method From January 2010 to December 2019, analysis was conducted retrospectively in a cohort from the National Health Insurance Service database. The wash-out period was set for cancer diagnosis in 2010 and 2011, and subjects (105,279) diagnosed with prostate cancer (ICD C61) from 2012 to 2014 were excluded The final subjects (105,216) were defined as the metformin administration group when they took metformin for 180 days or more from January 2012 to December 2019. The non-metformin group was defined as those who took less than 180 days from January 2012 to December 2019. The prevalence of prostate cancer according to metformin administration and the risk according to the cumulative duration of metformin were analyzed. Results A total of 105,216 people were included in this study, with 59,844 in the metformin group and 45,372 in the metformin non-administration group. When calculating HRs (Hazard Rate) according to the cumulative period of metformin administration, metformin administration period length was inversely associated with prostate cancer risk (Q2 HR = 0.791 95% CI: 0.773–0.81, Q3 HR = 0.634 95% CI: 0.62–0.649, Q4 HR = 0.571 95% CI: 0.558–0.585). HRs tended to decrease with the cumulative duration of metformin administration. Conclusion This study confirmed that prostate cancer risk decreased with increasing duration of metformin administration. Metformin should be considered as a new strategy in the treatment and prevention of prostate cancer characterized by heterogeneity.

Health Communication, Knowledge and Practice towards Prostate cancer in Kwara State, Nigeria

In response to the global call for strategic information to comprehend prostate cancer, this study evaluated the health communication on behavioral practice of prostate cancer in Kwara state, Nigeria. Existing studies in Nigeria on prostate cancer have mostly focused on health practitioners and their patients, ignoring specific empirical data on semi-urban and urban context. This study looks at health communication channels as predictors of knowledge, attitude, and behavioral practices, with a focus on Ilorin, Nigeria’s Kwara state, which has the highest prostate cancer prevalence rate. A total of 336 respondents from Kwara State, Nigeria, were randomly selected using the multistage sample procedure for the survey. The findings show Knowledge of prostate cancer was highest amongst study participants who used the radio (4.00 ± 1.06) and television (3.64 ± 0.51) while it was low amongst those who relied on the internet (3.48 ± 0.50) and health professionals (3.16 ± 0.66) as their primary source of information. Contrastingly, practice was highest amongst persons who used the internet (3.60 ± 0.20) as their primary information source and lowest amongst those who used the television (2.50 ± 1.52) and Health Professionals (2.44 ± 0.65). Demographically, respondents in the 46-55 age group scored the highest (3.93 ± 0.71) as compared to those in the 26-35 (3.43 ± 0.68) who scored the lowest on the knowledge scale.The study concludes that health communication outlets such as television, the Internet, radio, newspapers, and health workers have a good impact on the people of Ilorin, Kwara State, Nigeria. The study suggests creating a nationwide prostate cancer communication system to improve the knowledge, attitude and practice of people, towards the attainment of Sustainable Development Goal 3.

The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions detected by multiparametric MRI of the prostate.

44 Background: This study aimed to evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions detected by multiparametric MRI (mpMRI) of the prostate and underwent in-bore biopsy (IB). Methods: In this retrospective study, data of 295 patients who underwent IB for PI-RADS 4-5 lesions between 2012 and 2021 were analyzed, and a total of 159 patients with only PI-RADS 4 lesions were included. Clinical and radiological data, including age, PSA level, previous biopsy information, and the size and the number of PI-RADS 4 lesions were recorded. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC. Results: A great majority (86.8%) of the patients had undergone a biopsy for the first time. About three-fourths (71.7%) of the patients had PCa, and half (54.1%) had CSPC. In multivariate analysis, the relationship between PCa and age, index lesion size, low PSA levels, and first biopsy patients were found significant, while CSPC exhibited a significant relationship with age and first biopsy patients. When the patients were divided into three groups according to the index lesion size (&lt;5 mm, 5-10 mm, and &gt;10 mm), the prevalence of PCa was 64.3%, 67.5%, and 82.4% and the prevalence of CSPC was 42.9%, 51.2%, and 64.7% respectively. Conclusions: While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC. The number of lesions was insignificant in predicting both conditions. However, the prevalence of PCa was high, especially in patients with PI-RADS 4 lesions larger than 10 mm, which in turn increased the probability of the lesion being Grade Group 2 or above. [Table: see text]

Germline APC (I1307K) mutation and clinical outcomes in prostate cancer.

139 Background: The germline I1307K mutation in the adenomatous polyposis coli (APC) gene is a well-known alteration identified in approximately 6% of the Ashkenazi Jewish population. This mutation confers an increased risk of developing colorectal and other cancers. We previously reported high prevalence of aggressive variant prostate cancer (AVPC) in patients with the germline APC (I1307K) mutation. Herein, we report a larger case control analysis evaluating the hypothesis that AVPC is enriched in these patients. Methods: We reviewed records from New York University, Johns Hopkins University and Sheba Medical Center to identify patients with the APC (I1307K) mutation. Eligibility criteria included the identification of the mutation either on germline or somatic tissue testing (when germline testing was not available). AVPC was defined using previously established criteria. Combined somatic alterations in two or more of following genes were assessed: RB1, TP53, PTEN. These somatic alterations have been previously associated with AVPC. We compared cases with 21 controls with APC frameshift mutations. For categorical variables, the odds ratios (OR) for cases compared to controls are provided with 95% confidence intervals (CI). Continuous variables were summarized with descriptive statistics and compared between the case and control groups using 2-sided nonparametric Wilcoxon Rank Sum tests. Results: From 2016-2022, 18 patients at 3 institutions with the germline APC (I1307K) mutation and 21 controls at NYU with frameshift APC mutations were identified. Median ages did not differ between cases (73.5 years) and controls (71 years). At the time of analysis 13 cases (72%) and 18 (86%) controls were alive (OR: 0.43, 95% CI: 0.09, 1.24). The odds of metastatic disease among cases is 2.03 times that of controls (95% CI: 0.56, 7.32). Median PSA at diagnosis was 8 ng/mL (0.4-780) in cases and 12 ng/mL (4.7-1500) in controls. The odds of small cell histology (either on initial or subsequent biopsy) was 18 times greater than in controls (5 cases; 28% and 1 control; 5%). The odds of clinically-defined AVPC was 9.5 times greater in cases than in controls (9 cases; 50% and 2 controls; 10%, 95% CI: 1.69-53.3). In patients with metastatic disease at diagnosis 7/10 cases (70%) vs 0/9 controls had AVPC. The odds of combined somatic alterations in two or more of RB1, TP53 or PTEN was 5.1 times greater in cases than in controls (4 cases; 22% and 1 control; 5%, 95% CI: 0.58, 56.73). Conclusions: Prostate cancers that develop in the presence of the germline APC (I1307K) mutation appear to be enriched for clinically-defined and molecularly-defined AVPC compared to patients with frameshift APC mutations. The odds of combined somatic alterations in two or more of RB1, TP53 and PTEN were more common in cases than in the controls. Larger studies to identify the impact of germline APC (I1307K) mutation in the somatic genomic and epigenomic landscape of prostate cancer are ongoing.

Prevalence of prostate cancer in men with haematuria: a systematic review and meta-analysis.

To investigate the prevalence of prostate cancer in men attending evaluation for haematuria, as this could help healthcare providers to determine whether men with haematuria should have prostate examinations performed. The study was performed according to a pre-specified protocol uploaded to the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022299383). A systematic search of MEDLINE, Ovid and Google Scholar was performed in December 2021. Two independent researchers evaluated all titles, available abstracts, and full texts. We included studies on adult men (aged ≥18 years) describing haematuria and prostate cancer. We screened 4252 titles and abstracts when available and assessed 350 studies in full text. In total, 65 studies were included and 42 was summarised in a meta-analysis. In total, 18 752 men with haematuria were included, and the pooled prevalence (95% confidence interval [CI]) of prostate cancer was 3.0%(2.0-4.1%). In men with macroscopic haematuria, the pooled prevalence (95% CI) of prostate cancer was 5.9%(2.9-9.9%; n= 265/5373). In men with microscopic haematuria, the pooled prevalence (95% CI) of prostate cancer was 1.4% (0.8-2.2%; n= 71/6642). Our findings indicate that the prevalence of prostate cancer is considerable in men attending evaluation for haematuria. Therefore, digital rectal examination and prostate-specific antigen measurement should become a standard procedure for all men with haematuria, especially for men with macroscopic haematuria.

Abstract A017: The geospatial analysis of the socioeconomic status and its impact on prostate cancer prevalence in Alabama

Abstract Background: This study aims to understand the impact of Socioeconomic status (SES) and how it influences the aging population, increasing the risk of many diseases, including prostate cancer. The cancer prevalence in Alabama is high; prostate cancer rates are particularly high in the diverse male populations. Alabama's Black Belt rural counties are closely associated with socioeconomic and health disparities, and political oppression, among which social equity and socioeconomic status have been closely associated with prostate cancer incidence. This study explores prostate cancer occurrence in the aging population in the major ethnic groups (African American and Whites) in the State of Alabama, mainly in the black belt of Alabama. Prior studies have revealed that prostate cancer prevalence is related to biological, environmental, and socioeconomic characteristics. A precise sense of the root causes of the age-related increase in prostate cancer incidence is required to develop a strategy for building primary spatial and non-spatial cancer data using machine-learning tools. Hypothesis/Objectives: We hypothesized that SES might impact prostate cancer occurrence among the aging population. Our study aims to explore the impact of SES factors to understand prostate cancer incidence in the aging population in Alabama. Methods: We utilized Geospatial Technology (GT) to analyze the connection between aging and prostate cancer prevalence in different ethnic populations in Alabama. This study incorporated county-level prostate cancer prevalence and association with aging, SES, and health disparities. The robust data mining (Alabama Department of Senior Services, Alabama State Cancer Profile data, Alabama Department of Health, American Cancer Society, Center for Disease Control, and National Cancer Institute) enabled us to explore the association between aging and prostate cancer in the spatial context. Integrating spatial and non-spatial data on prostate cancer prevalence to SES will help predict and formulate prostate cancer prevention methods. Results: The GT's secondary data analysis revealed that prostate cancer affects minority communities in the Black Belt in Alabama. The GT analysis further demonstrates that this disparity is due to a lack of access to health care and mitigation efforts. The diverse data integration reveals that the SES and related factors modulate the aging population and prostate cancer occurrence. Conclusions: The preliminary finding demonstrates that SES is an essential factor that modulates prostate cancer incidences in underserved minority aging populations in Alabama. Hence, understanding the association between aging and socioeconomic disparities will help predict and prevent prostate cancer more effectively. Citation Format: Manoj K. Mishra, Seela Aladuwaka, Ram Alagan. The geospatial analysis of the socioeconomic status and its impact on prostate cancer prevalence in Alabama [abstract]. In: Proceedings of the AACR Special Conference: Aging and Cancer; 2022 Nov 17-20; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2022;83(2 Suppl_1):Abstract nr A017.

The role of the size and number of index lesion in the diagnosis of clinically significant prostate cancer in patients with PI-RADS 4 lesions who underwent in-bore MRI-guided prostate biopsy.

To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions. In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC. A great majority (86.8%) of the patients were biopsy-naïve. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5mm, 5-10mm, and > 10mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50ml) and being biopsy-naïve were found significant for PCa, while age and prostate volume (< 50ml) were significant for CSPC. The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.

Evaluation of automatic discrimination between benign and malignant prostate tissue in the era of high precision digital pathology

BackgroundProstate cancer is a major health concern in aging men. Paralleling an aging society, prostate cancer prevalence increases emphasizing the need for efficient diagnostic algorithms.MethodsRetrospectively, 106 prostate tissue samples from 48 patients (mean age, 66pm 6.6 years) were included in the study. Patients suffered from prostate cancer (n = 38) or benign prostatic hyperplasia (n = 10) and were treated with radical prostatectomy or Holmium laser enucleation of the prostate, respectively. We constructed tissue microarrays (TMAs) comprising representative malignant (n = 38) and benign (n = 68) tissue cores. TMAs were processed to histological slides, stained, digitized and assessed for the applicability of machine learning strategies and open–source tools in diagnosis of prostate cancer. We applied the software QuPath to extract features for shape, stain intensity, and texture of TMA cores for three stainings, H&E, ERG, and PIN-4. Three machine learning algorithms, neural network (NN), support vector machines (SVM), and random forest (RF), were trained and cross-validated with 100 Monte Carlo random splits into 70% training set and 30% test set. We determined AUC values for single color channels, with and without optimization of hyperparameters by exhaustive grid search. We applied recursive feature elimination to feature sets of multiple color transforms.ResultsMean AUC was above 0.80. PIN-4 stainings yielded higher AUC than H&E and ERG. For PIN-4 with the color transform saturation, NN, RF, and SVM revealed AUC of 0.93pm 0.04, 0.91pm 0.06, and 0.92pm 0.05, respectively. Optimization of hyperparameters improved the AUC only slightly by 0.01. For H&E, feature selection resulted in no increase of AUC but to an increase of 0.02–0.06 for ERG and PIN-4.ConclusionsAutomated pipelines may be able to discriminate with high accuracy between malignant and benign tissue. We found PIN-4 staining best suited for classification. Further bioinformatic analysis of larger data sets would be crucial to evaluate the reliability of automated classification methods for clinical practice and to evaluate potential discrimination of aggressiveness of cancer to pave the way to automatic precision medicine.

Role of microbiome and its metabolite, short chain fatty acid in prostate cancer.

The microbiome which is an assembly of all microbes living inside our bodies performs a major role in maintaining human health and wellness. It has been found that the imbalance of the microbiome can cause various diseases in humans. Similarly, there is growing evidence that the microbiome largely affects a person's chance of contracting certain cancers and how the disease develops and progresses. Studies have shown that about 15% to 20% of all cancers are caused by microbial pathogens. The prevalence of prostate cancer, which is increasing rapidly in Korea, is related to lifestyle including diet. These diets can alter the gut microbial composition, and the effect of the microbiome on prostate cancer development can be estimated. However, the microbiome associated with prostate cancer has been reported differently according to race. This means that the metabolite rather than the specific microbiome will be important. Short chain fatty acids, metabolites of the microbiome, plays an important role in the action mechanism of the microbiome. Short chain fatty acids play roles such as immunomodulation and inhibition of histone deacetylase. Here, we examined the most up-to-date literature featuring the effects of the microbiome on the risk and pathogenesis of prostate cancer.

Prostate tumor markers: diagnosis, prognosis and management.

Prostate cancer (PCA) is the second most common type of cancer in the world. Nevertheless, diagnosis is still based on nonspecific methods, or invasive methods which makes clinical decision and diagnosis difficult, generating risk of both underdiagnosis and overdiagnosis. Given the high prevalence, morbidity and mortality of PCA, new strategies are needed for its diagnosis. A review of the literature on available biomarkers for PCA was performed, using the following terms: prostate cancer AND marker OR biomarker. The search was carried out in Pubmed, Science Direct, Web of Science and Clinical Trial. A total of 35 articles were used, and PHI (Prostate Health Index) and the 4Kscore tests were identified as the best well-established serum markers. These tests are based on the evaluation of expression levels of several molecules. For analysis of urine samples, Progensa, ExoDXProstate, and Mi Prostate Score Urine Test are available. All these tests have the potential to help diagnosis, avoiding unnecessary biopsies, but they are used only in association with digital rectal examination and PSA level data. The search for biomarkers that can help in the diagnosis and therapeutic management of PCA is still in its initial phase, requiring more efforts for an effective clinical application.

The Myths and Realities of Prostate Cancer Chemoprevention – A Journey Through Scientific Evidences

The goals of primary chemoprevention of any disease include decreasing the incidence of disease, reducing treatment-related adverse events, cutting down the cost of treatment and bringing down the mortality due to the disease. Increased prevalence of prostate cancer and identification of large numbers of newly detected disease due to the availability of better screening measures, long latency of the disease and peculiar molecular basis of pathogenesis make prostate cancer an attractive target of chemoprevention. This article reviews the experimental and epidemiological data available from 1998 to 2023 on the effectiveness, safety and toxicity of various nutritional and other agents proposed to be used for prostate cancer chemoprevention either to reduce the incidence of this cancer and/or slow down the disease progression. No single agent has been categorically proved to be the best for chemoprevention of prostate cancer as of now. Although majority of studies do not propose adopting chemoprevention in the entire elderly men population, it may be ideal that the men at higher risk of contracting prostate cancer like those having positive family history would be the best choice for implementing chemoprevention.

Screening for Prostate Cancer: Role of Free Psa, Psad with Prostate Biopsy Findings and Digital Rectal Examination

Background and Aim The incidence of various cancers including the prostate, is on the rise globally. Prostate cancer is one of the most frequently reported cancer in men worldwide. This study was done to study the correlation of free PSA, percentage free PSA, and PSAD, with prostate biopsy findings, and the role of DRE in screening for carcinoma prostate. Methods The cross-sectional, correlational study was conducted at a tertiary care hospital in Coastal Kerala, over a period of 18 months in a sample size of 100 patients. The following was the study outline followed; Results The prevalence of prostate cancer was found to be 41%, maximum number of patients were in the age group of 50 -70 years of age. Percentage free PSA (%fPSA) and prostate volume were found to vary significantly between patients with Benign Prostate Hyperplasia and prostate cancer. At a cut off of 0.15, PSA density was seen to significantly vary between patients with BPH and prostate cancer. At a cut off of 15% (chosen based on prior studies), %fPSA was seen to significantly vary between patients with BPH and prostate cancer. The sensitivity and specificity of %fPSA were 73.17% and 93.22% respectively. Digital rectal examination varied significantly between patients with benign enlargement and those with malignancy. However, false positive rate with DRE alone was 44.06%. Conclusion DRE continues to be a useful screening technique as a part of clinical examination to identify patients who should undergo further screening for prostate cancer such as PSA estimation, free PSA estimation, and if required, a prostate biopsy, but DRE alone cannot be used to make accurate clinical decision owing to the false positives. Percentage fPSA could be a useful tool that can be used to avoid unnecessary biopsies in patients with a PSA range between 4.0 – 10.0 ng/ml.

Zinc in Prostate Health and Disease: A Mini Review.

Introduction-With the high global prevalence of prostate cancer and associated mortalities, it is important to enhance current clinical practices for better prostate cancer outcomes. The current review is towards understanding the value of Zn towards this mission. Method-General information on Zn in biology and multiple aspects of Zn involvement in prostate health and disease were referred to in PubMed. Results-The most influential feature of Zn towards prostate health is its ability to retain sufficient citrate levels for a healthy prostate. Zn deficiencies were recorded in serum, hair, and prostate tissue of men with prostate cancer compared to non-cancer controls. Zn gut absorption, albumin binding, and storage compete with various factors. There are multiple associations of Zn cellular influx and efflux transporters, Zn finger proteins, matrix metalloproteinases, and Zn signaling with prostate cancer outcomes. Such Zn marker variations associated with prostate cancer recorded from biological matrices may improve algorithms for prostate cancer screening, prognosis, and management when coupled with standard clinical practices. Discussion-The influence of Zn in prostatic health and disease is multidimensional, therefore more personalized Zn requirements may be beneficial. Several opportunities exist to utilize and improve understanding of Zn associations with prostate health and disease.