A COMPARATIVE STUDY OF THE RELEVANCE OF DRE, TRUS, AND PSA IN THE DIAGNOSTIC EVALUATION OF PATIENTS WITH CARCINOMA OF THE PROSTATE.

Abstract

Carcinoma of the prostate (CaP) is currently the most frequently diagnosed cancer among males . Although it was initially thought to be uncommon in Africans, recent studies have shown that the incidence and prevalence rates are higher in Africans than in age-matched African-Americans. The clinical outcome is also known to be relatively poor among blacks who typically present for treatment at advanced stages of the disease and at relatively younger ages .Before the advent of sophisticated diagnostic techniques, the diagnosis of carcinoma of prostate was mainly done with digital rectal examination (DRE) with the attendant limitations as it was only useful in detecting advanced diseases. Previous studies have also shown that the ndings and conclusions reached at DRE were subjective and observer dependent . The subsequent introduction of the transrectal ultrasound (TRUS), which was greeted with much expectation with the hope that it would assist in detecting cancer nodules eluding detection by DRE turned out to be a disappointment . Nevertheless, the introduction of the serum prostate-specic antigen (PSA) test brought about a revolution in the diagnosis of CaP since it allowed the detection of the disease in its early stages. This resulted in a signicant reduction in the number of cases of CaP diagnosed at advanced stages. Since then, researchers have concentrated on the merits and demerits of the PSA in the early detection of CaP . In recent times, however, controversies have trailed the use of the PSA in the screening and early diagnosis of CaP since it is becoming apparent that serum PSA estimation has some signicant drawbacks in the evaluation of patients with prostatic disorders . Although a larger percentage of cases of carcinoma of prostate are still being diagnosed at advanced stages in most African nations, only extremely very few studies have examined the role of serum PSA in the management of such cases . Thus, the aim of this study was to compare the diagnostic yield of DRE, TRUS scan and PSA in the diagnostic evaluation of advanced carcinoma.