A STUDY OF PROSTATE CANCER DETECTION RATES IN MEN UNDERGOING TRANS-RECTAL ULTRASOUND-GUIDED PROSTATE BIOPSY AT KATH, KUMASI

Abstract

Introduction: Prostate cancer is the second most common cancer among men worldwide. The risk of developing prostate cancer increases with advancing age, elevated serum PSA level, a family history of prostate cancer, and being black or of African ancestry. The diagnosis of prostate cancer is made by histopathological evaluation of the prostate gland. TRUS-guided biopsy of the prostate gland is the gold standard technique for obtaining prostate gland specimen for histopathological evaluation of the prostate gland and for the diagnosis of prostate cancer. This study sought to evaluate the prostate cancer detection rate of TRUS-guided prostate biopsy and analyze its characteristics among the men undergoing prostate biopsy at Komfo Anokye Teaching Hospital, Kumasi. Method: A total of 218 men were referred on various indications for TRUS-guided prostate biopsies at the Urology Unit of the Directorate of Surgery of the Komfo Anokye Teaching Hospital from September 2022 to October 2023 participated in this study. The study participants were prospectively evaluated, and the data analyzed to determine the prostate cancer detection rate and its characteristics. Results: The mean age of the study participants was 69.84 + 8.10 years with a range of 45 - 89 years. Of the 218 men who underwent-guided prostate biopsy, 121 (55.5%) were detected to have adenocarcinoma of the prostate whilst 97 (44.5%) had no cancer. The indications for prostate biopsy from this study were elevated serum PSA level (61.5%), suspicious DRE findings (32.1%) and a combination of both (6.4%). The cancer detection rates for men who underwent biopsy with indications of suspicious DRE findings alone, abnormal serum PSA levels alone, and a combination of both were 14.3, 50.4 and 67.9%. The cancer detection rate was found in the study to increase with increasing serum PSA level and advancing age, and decreases with increasing volume of the prostate gland in the study population. Conclusion: TRUS-guided biopsy of the prostate gland detects more prostate cancer cases than non-cancer cases. The indication with the highest positive predictive value for prostate cancer was the presence of both elevated serum PSA level and suspicious DRE findings. The risk of diagnosis increases with increasing levels of serum PSA and advancing age in the study population. Whilst the risk of being diagnosed with prostate cancer decreases with increasing prostate volume (size).