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Population based prostate cancer screening in north Mexico reveals a high prevalence of aggressive tumors in detected cases.

Gomez-Guerra LS, Martinez-Fierro ML, Alcantara-Aragon V, Ortiz-Lopez R, Martinez-Villarreal RT, Morales-Rodriguez IB, Garza-Guajardo R, Ponce-Camacho MA, Rojas-Martinez A - BMC Cancer (2009)

Bottom Line: Based on the PSA (>4.0 ng/ml) and DRE results, subjects were appointed for transrectal biopsy (TRB).Prostate biopsy was recommended to 125 men based on PSA values and DRE results, but it was performed in only 55 of them. 15 of these biopsied men were diagnosed with PCa, mostly with Gleason scores > or = 7.Our results reflect a low prevalence of PCa in general, but a high occurrence of high grade lesions (Gleason > or = 7) among patients that resulted positive for PCa.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Medicine and University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. laurogomez@hotmail.com

ABSTRACT

Background: Prostate Cancer (PCa) is the second most frequent neoplasia in men worldwide. Previous reports suggest that the prevalence of PCa in Hispanic males is lower than in Africans (including communities with African ancestry) and Caucasians, but higher than in Asians. Despite these antecedents, there are few reports of open population screenings for PCa in Latin American communities. This article describes the results of three consecutive screenings in the urban population of Monterrey, Mexico.

Methods: After receiving approval from our University Hospital's Internal Review Board (IRB), the screening was announced by radio, television, and press, and it was addressed to male subjects over 40 years old in general. Subjects who consented to participate were evaluated at the primary care clinics of the University Health Program at UANL, in the Metropolitan area of Monterrey. Blood samples were taken from each subject for prostate specific antigen (PSA) determination; they underwent a digital rectal examination (DRE), and were subsequently interviewed to obtain demographic and urologic data. Based on the PSA (>4.0 ng/ml) and DRE results, subjects were appointed for transrectal biopsy (TRB).

Results: A total of 973 subjects were screened. Prostate biopsy was recommended to 125 men based on PSA values and DRE results, but it was performed in only 55 of them. 15 of these biopsied men were diagnosed with PCa, mostly with Gleason scores > or = 7.

Conclusion: Our results reflect a low prevalence of PCa in general, but a high occurrence of high grade lesions (Gleason > or = 7) among patients that resulted positive for PCa. This observation remarks the importance of the PCa screening programs in our Mexican community and the need for strict follow-up campaigns.

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Related in: MedlinePlus

Age distribution of biopsied subjects (n = 55).
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Figure 1: Age distribution of biopsied subjects (n = 55).

Mentions: Overall, fifty-five core biopsies from 124 subjects with suspicion of PCa (by PSA and DRE criteria) were submitted for pathological evaluation and a total of 15 cases of PCa were found in the screenings. The typical features of prostatic carcinoma like a single epithelial layered gland, huge nucleolus and conspicuous nucleoli were observed; some of the glands showed back to back pattern of growth, lymphatic and vascular infiltration; 14 of the carcinomas (93%) had Gleason scores equal or above 7. Sixty seven percent of the subjects with PCa had moderate to severe obstructive symptoms according to their AUA-SI scores. None of the men with prostate cancer had a history of PCa in their families, and only 2 had a family history of other types of cancer (Colon Ca, and Breast Ca). Most of the subjects with PCa (66.6%) were overweight, with a Body Mass Index (BMI) equal or above 25. Only one of these subjects was reported as smoker at the time of the interview and seven (46.6%) were taking nutritional supplements, mostly multivitamin compounds. Table 1 shows Age, BMI and AUA data for these subjects compared with general population. 98 screened patients were older than 75 years (10.07%). The age distribution of subjects that underwent biopsy (Figure 1) shows that PCa was diagnosed in 12/37 subjects from 40 to 74 years old (32.43%), while this tumor was diagnosed in 3/6 subjects older than 75 years old (50.0%).


Population based prostate cancer screening in north Mexico reveals a high prevalence of aggressive tumors in detected cases.

Gomez-Guerra LS, Martinez-Fierro ML, Alcantara-Aragon V, Ortiz-Lopez R, Martinez-Villarreal RT, Morales-Rodriguez IB, Garza-Guajardo R, Ponce-Camacho MA, Rojas-Martinez A - BMC Cancer (2009)

Age distribution of biopsied subjects (n = 55).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2666762&req=5

Figure 1: Age distribution of biopsied subjects (n = 55).
Mentions: Overall, fifty-five core biopsies from 124 subjects with suspicion of PCa (by PSA and DRE criteria) were submitted for pathological evaluation and a total of 15 cases of PCa were found in the screenings. The typical features of prostatic carcinoma like a single epithelial layered gland, huge nucleolus and conspicuous nucleoli were observed; some of the glands showed back to back pattern of growth, lymphatic and vascular infiltration; 14 of the carcinomas (93%) had Gleason scores equal or above 7. Sixty seven percent of the subjects with PCa had moderate to severe obstructive symptoms according to their AUA-SI scores. None of the men with prostate cancer had a history of PCa in their families, and only 2 had a family history of other types of cancer (Colon Ca, and Breast Ca). Most of the subjects with PCa (66.6%) were overweight, with a Body Mass Index (BMI) equal or above 25. Only one of these subjects was reported as smoker at the time of the interview and seven (46.6%) were taking nutritional supplements, mostly multivitamin compounds. Table 1 shows Age, BMI and AUA data for these subjects compared with general population. 98 screened patients were older than 75 years (10.07%). The age distribution of subjects that underwent biopsy (Figure 1) shows that PCa was diagnosed in 12/37 subjects from 40 to 74 years old (32.43%), while this tumor was diagnosed in 3/6 subjects older than 75 years old (50.0%).

Bottom Line: Based on the PSA (>4.0 ng/ml) and DRE results, subjects were appointed for transrectal biopsy (TRB).Prostate biopsy was recommended to 125 men based on PSA values and DRE results, but it was performed in only 55 of them. 15 of these biopsied men were diagnosed with PCa, mostly with Gleason scores > or = 7.Our results reflect a low prevalence of PCa in general, but a high occurrence of high grade lesions (Gleason > or = 7) among patients that resulted positive for PCa.

View Article: PubMed Central - HTML - PubMed

Affiliation: School of Medicine and University Hospital, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico. laurogomez@hotmail.com

ABSTRACT

Background: Prostate Cancer (PCa) is the second most frequent neoplasia in men worldwide. Previous reports suggest that the prevalence of PCa in Hispanic males is lower than in Africans (including communities with African ancestry) and Caucasians, but higher than in Asians. Despite these antecedents, there are few reports of open population screenings for PCa in Latin American communities. This article describes the results of three consecutive screenings in the urban population of Monterrey, Mexico.

Methods: After receiving approval from our University Hospital's Internal Review Board (IRB), the screening was announced by radio, television, and press, and it was addressed to male subjects over 40 years old in general. Subjects who consented to participate were evaluated at the primary care clinics of the University Health Program at UANL, in the Metropolitan area of Monterrey. Blood samples were taken from each subject for prostate specific antigen (PSA) determination; they underwent a digital rectal examination (DRE), and were subsequently interviewed to obtain demographic and urologic data. Based on the PSA (>4.0 ng/ml) and DRE results, subjects were appointed for transrectal biopsy (TRB).

Results: A total of 973 subjects were screened. Prostate biopsy was recommended to 125 men based on PSA values and DRE results, but it was performed in only 55 of them. 15 of these biopsied men were diagnosed with PCa, mostly with Gleason scores > or = 7.

Conclusion: Our results reflect a low prevalence of PCa in general, but a high occurrence of high grade lesions (Gleason > or = 7) among patients that resulted positive for PCa. This observation remarks the importance of the PCa screening programs in our Mexican community and the need for strict follow-up campaigns.

Show MeSH
Related in: MedlinePlus