Clinical characteristics of prostate cancer patients from community or outpatient service center of PSA-based screening in China

Abstract

Purpose To establish an effective prostate cancer (PCa) screening method for developing countries and to compare the clinical characteristics of prostate cancer patients from community and outpatient service centers screened with corresponding prostate-specific antigen (PSA)-based screening programs in China. Materials and Methods We summarized the annual individual data of patients with transrectal ultrasound (TRUS) prostate biopsy-confirmed PCa from PSA-based population screening methods in Huai’an, China and analyzed the PCa detection rates separately for patients screened with community service center (CSC) and outpatient service center (OSC) methods. The distributions of categorical clinical characteristics, including age, prostate volume, serum testosterone level, PSA level, degree of lower urinary tract symptoms (LUTS), position or Prostate Imaging-Reporting and Data System (PI-RADS) grade of abnormal lesions, Gleason score, International Society of Urological Pathology (ISUP) grade and treatment management approach, were compared between the two groups with the appropriate statistical tests. Results From January 1, 2022, to December 31, 2022, a total of 441 participants underwent prostate biopsy, including 198 men screened with the CSC method and 243 men screened with the and OSC method. Participants screened with the CSC method had lower ages, prostate volumes, and PSA parameter values, including total PSA (tPSA) level and PDA density (PSAD), than did those screened with the OSC method. Furthermore, the curative approach was more effective for PCa patients screened with the CSC method than for those screened with the OSC method, as reflected in a lower Gleason score, lower ISUP stage and earlier TNM stage. Conclusions The results of this study suggested that PCa patients screened with community screening methods have earlier disease stages and a better chance of receiving curative treatment than those screened with outpatient screening methods. The results of this study could serve as an important reference for gradually establishing comprehensive screening patterns and follow-up systems in China and other developing countries.