CURRENT STATUS AND PROBLEMS OF A SCREENING FOR PROSTATIC CANCER IN DOCK IN FUKUOKA PREFECTURE

We analyzed the current status and problems of a screeing for prostatic cancer (PCa) through a health examination in 12 hospitals in Fukuoka prefecture. From 1987 to 1991, a total of 16, 126 subjects received this. The number of subjects who received this increased every year. In 5 hospitals in which such a screening is optional, however, only about 20% of subjects through a health examination received it each year. Furthermore, most of the subjects were in their 50s or 40s. Those in their 70s or more who are at higher risk for PCa rarely received such screening. PCa was detected in 6 subjects (0.04%) (well differentiated adenocarcinoma: 3, moderate differentiated adenocarcinoma: 3) in 5 years. Five were in stage B and treated with radical prostatectomy and one was in stage C and hormonal therapy was performed. The mean age of the 6 patients was 57.7 year old ranging from 51 to 66. The incidence of PCa detected by a screening in dock increased with age. Prostate specific antigen (PSA) was considered to be more useful for detecting prostate cancer in dock as compared with digital examination (DRE), transrectal ultrasonography or prostatic acid phosphatase because of its relatively high sensitivity (83.3%) and specificity (84.8%). The incidence of PCa detected with combination of DRE and determination of PSA was 0.15% and significantly higher than that detected with DRE alone, 0.01%. These results suggest the need for enlightenment on PCa and the significance of a screening with combination of DRE and determination of PSA through a health examination for detecting early stage of PCa.