Detection Rate of Prostate Cancer According to Prostate-Specific Antigen and Digital Rectal Examination in Korean Men: A Nationwide Multicenter Study

Abstract Objectives To evaluate the detection rate of prostate cancer on biopsies taken according to levels of serum prostate-specific antigen (PSA), digital rectal examinations (DRE), and age of Korean men. Methods We examined 4967 Korean men over 40 years of age who underwent prostate biopsies in 25 hospitals from October 2004 to July 2006. Prostate biopsies were performed when PSA levels were more than 4.0 ng/mL or the DRE was suspect. Results Of the 4967 men examined, 1621 (32.7%) were diagnosed with prostate cancer. Further interpretation revealed that 19.6% of subjects with PSA levels between 4.0 and 9.9 ng/mL were diagnosed with cancer, whereas 53.7% were diagnosed at PSA levels greater than 10 ng/ml. Normal DRE findings with elevated serum PSA levels were divided into three subgroups: 4.0 to 9.9 ng/mL, 10.0 to 19.9 ng/mL, and more than 20.0 ng/mL. The corresponding rates of cancer detection ranged at 17.0%, 25.9%, and 58.6%, respectively. In addition, cancer was detected in 33.4% of subjects with serum PSA levels of 4.0 to 9.9 ng/mL and a DRE suspicious of cancer. The detection rate of prostate cancer in biopsies with normal DRE findings in subjects aged 40 to 49 years, 50 to 59 years, 60 to 69 years, and 70 or more years was 7.6%, 16.5%, 22.8%, and 29.8%, respectively. Conclusions Detection rates of prostate cancer in biopsies were lower than those found for white men. The data thaws indicative that ethnic differences exist with regard to detection rates of prostate cancer.