Usefulness of screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("Human Dock") at Onomichi Municipal Hospital: Clinical significance of the cases diagnosed as prostate cancer

(Purpose) The usefulness of the screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("Human Dock") at Onomichi Municipal Hospital was evaluated. (Methods) From April 1997 to December 2007, serum PSA of 1,234 male (median age: 59) was measured in the medical checkup and each parameter of screening was evaluated. In addition, for the cases with prostate cancer, results of treatment and clinical significance were assessed. (Results) PSA was elevated in 82 cases (6.6%), aged 42-87 (median 64), in which PSA varied 3.1-66.5ng/ml (median 5.4). Trans-rectal biopsy was performed in 35 cases and prostate cancer was detected in 15 (42.9% of biopsied cases and 1.2% of whole group), aged 58-81 (median 70), with PSA value 4.2-66.5ng/ml (median 10.3). Clinical stage of these cases was cTlcNOMO in 12 and cT2aN0M0 or more in 3, Gleason score was 3 + 3 in 4 and 3 + 4 or more in 11. Initial treatment was radical prostatectomy in 12, androgen-deprivation therapy in 2 and external beam irradiation in 1. During the follow-up for 8-107 months (median 60), 14 were alive with good control and 1 was alive with relapse. Only one case was "clinically insignificant" cancer (impalpable and localized and tumor volume less than 0.5ml and Gleason score 3 + 3 or less).