Prostate cancer screening among elderly men in Brazil: should we diagnose or not?



Título del documento: Prostate cancer screening among elderly men in Brazil: should we diagnose or not?
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000434660
ISSN: 1677-5538
Autors: 1
2
2
1
1
Institucions: 1Universidade de Sao Paulo, Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, Sao Paulo. Brasil
2Hospital de Cancer de Barretos, Barretos, Sao Paulo. Brasil
Any:
Període: Ene-Feb
Volum: 46
Número: 1
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Purpose: Prostate cancer screening in the elderly is controversial. The Brazilian government and the National Cancer Institute (INCA) do not recommend systematic screening. Our purpose was to assess prevalence and aggressiveness of prostate cancer in men aged 70 years and above, on the first Latin American database to date. Materials and Methods: Cross-sectional study (n=17,571) from 231 municipalities, visited by Mobile Cancer Prevention Units of a prostate-specific antigen (PSA) based opportunistic screening program, between 2004 and 2007. The criteria for biopsy were: PSA>4.0ng/ml, or PSA 2.5-4.0ng/ml with free/total PSA ratio ≤15%, or suspicious digital rectal examination findings. The screened men were stratified in two age groups (45-69 years, and ≥70 years). These groups were compared regarding prostate cancer prevalence and aggressiveness criteria (PSA, Gleason score from biopsy and TNM staging). Results: The prevalence of prostate cancer found was 3.7%. When compared to men aged 45-69 years, individuals aged 70 years and above presented cancer prevalence about three times higher (prevalence ratio 2.9, p<0.01), and greater likelihood to present PSA level above 10.0ng/ml at diagnosis (odds ratio 2.63, p<0.01). The group of elderly men also presented prevalence of histologically aggressive disease (Gleason 8-10) 3.6 times higher (p<0.01), and 5-fold greater prevalence of metastases (PR 4.95, p<0.05). Conclusions: Prostate cancer screening in men aged over 70 may be relevant in Brazil, considering the absence of systematic screening, higher prevalence and higher probability of high-risk disease found in this age range of the population studied
Disciplines Medicina
Paraules clau: Urología,
Oncología,
Diagnóstico,
Neoplasias,
Próstata,
Detección temprana,
Adultos,
Tamizaje
Keyword: Urology,
Oncology,
Diagnosis,
Neoplasms,
Prostate,
Early detection,
Adults,
Screening
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