TY - JOUR
T1 - Incidence and pathological characteristics of prostate cancer in Italy
T2 - A contribution to the screening debate
AU - Picone, Gennaro Maria
AU - Pizzi, Claudia
AU - Quartuccio, Antonio
AU - Scognamiglio, Giuseppe
AU - Tauchmanova, Libuse
AU - Di Maio, Massimo
AU - Cifarelli, Pierceleste
AU - Contegiacomo, Alma
PY - 2006
Y1 - 2006
N2 - Background: The scientific, social and financial aspects of prostate cancer (PC) organized or opportunistic screening to identify early PC are hotly debated. The incidence of prostate cancer is lower in Italy than in America and North Europe and data on PC incidence and pathological characteristics are scarce. Methods: To determine PC incidence and whether screening would be beneficial, we studied 1008 consecutive symptomatic patients from the Southern Italy who underwent transrectal ultrasonography; 170 of them (age range: 48-93 years; median: 70 years) were at risk and underwent transrectal biopsy. Results: Adenomatous hyperplasia was detected in 105 patients (62%), PC in 51 (30%), prostate intraepithelial neoplasia (PIN) in 5 (3%) and inflammatory disease in 5 (3%). The median age of patients with PC was 73.5 and tumors were generally well to moderately differentiated (76%, Gleason score ≤7). Prostate cancer (or PIN) was more frequent in patients over 70 (p <0.0001). The Gleason score also increased with age: >7 in 92% and 8% of patients aged >70 and ≤70, respectively (p <0.05). Conclusions: On the basis of our results organized or opportunistic PC screening of elderly men does not appear justified because: invasive carcinoma is detected in less than 1/3 of symptomatic "healthy" men; patients became symptomatic when their life expectancy is often less than 10 years; and PC is more frequent and more aggressive after 70 years.
AB - Background: The scientific, social and financial aspects of prostate cancer (PC) organized or opportunistic screening to identify early PC are hotly debated. The incidence of prostate cancer is lower in Italy than in America and North Europe and data on PC incidence and pathological characteristics are scarce. Methods: To determine PC incidence and whether screening would be beneficial, we studied 1008 consecutive symptomatic patients from the Southern Italy who underwent transrectal ultrasonography; 170 of them (age range: 48-93 years; median: 70 years) were at risk and underwent transrectal biopsy. Results: Adenomatous hyperplasia was detected in 105 patients (62%), PC in 51 (30%), prostate intraepithelial neoplasia (PIN) in 5 (3%) and inflammatory disease in 5 (3%). The median age of patients with PC was 73.5 and tumors were generally well to moderately differentiated (76%, Gleason score ≤7). Prostate cancer (or PIN) was more frequent in patients over 70 (p <0.0001). The Gleason score also increased with age: >7 in 92% and 8% of patients aged >70 and ≤70, respectively (p <0.05). Conclusions: On the basis of our results organized or opportunistic PC screening of elderly men does not appear justified because: invasive carcinoma is detected in less than 1/3 of symptomatic "healthy" men; patients became symptomatic when their life expectancy is often less than 10 years; and PC is more frequent and more aggressive after 70 years.
KW - Gleason score
KW - Neoplasms in the elderly
KW - PIN
KW - Prostate cancer detection
KW - Prostate cancer prevention
KW - Prostate cancer screening
KW - PSA
KW - Transrectal ultrasound (TRUS)
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U2 - 10.1016/j.cdp.2006.07.009
DO - 10.1016/j.cdp.2006.07.009
M3 - Article
C2 - 17067751
AN - SCOPUS:33751016379
VL - 30
SP - 455
EP - 458
JO - Cancer Detection and Prevention
JF - Cancer Detection and Prevention
SN - 0361-090X
IS - 5
ER -