Population-based Prostate Cancer Screening in Kazakhstan
-
Yevgeniy ISHKININ
,
Alma ZHYLKAIDAROVA
,
Nurzhan NURGALIYEV
,
Elmira AUYEZOVA
,
Ainash OSHIBAYEVA
,
Nadezhda GORBUNOVA
Abstract
Background: Issues of mass screening for prostate cancer rather controversial since 2013 in 11 regions of Kazakhstan introduced a population-based screening for prostate cancer, so we need to evaluate its results.
Methods: In different regions of Kazakhstan during 2013-2015, a total of 321548 prostate-specific antigens (PSA) were determined in men aged 50-66 yr, under the Prostate Health Index (PHI) and transrectal ultrasonography (TRUS) guided prostate biopsy with histological examination.
Results: PSA level up to 4 ng/ml in 310870 (96.7%) men, PSA level between 4 and 10 ng/ml in 8 624 (2.7%) men, PSA level above 10 ng/ml in 2054 (0.6%) men. PHI was identified in 5716 (1.8%) men, of which 2867 cases were with PHI ≥ 25 (35.9%). Totally, 3680 biopsies (1.1%) of the prostate were performed. As part of the screening, 2870 cases (0.88%) of benign prostatic hyperplasia and prostatic intraepithelial neoplasia were found. Of 742 cases of prostate cancer (0.23%) were revealed. The stages of prostate cancer screening were as follows: stage I in 172 men (23.2%), stage II in 444 men (59.8%), stage III in 98 men (13.2%) and stage IV in 28 (3.8%) men. The indicators of prostate cancer early diagnosis in the I-II stages were bigger in the “screening regions” than in the “traditional diagnostics” regions: RR 1.35 95% CI (1.24 – 1.46), OR 1.84 95% CI (1.58–2.15). Prostate cancer was detected at I-II stages in the "screening" regions only by screening vs traditional diagnostics, with RR 1.64 95% CI (1.56 – 1.73), OR 4.77 95% CI (3.87–5.87).
Conclusion: Implementation of screening can improve the diagnosis of prostate cancer in the early stages.
Ferlay J, Soerjomataram I, Ervik M, et al (2013). GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11 (Internet) Lyon, France: International Agency for Research on Cancer. http://globocan.iarc.fr
Arzykulov ZhA, Nurgaziev KSh, et al (2001 - 2015). Statistical materials: indicators of oncological service Republic of Kazakhstan. Kazakh Institute oncology & radiology, Almaty
Davidson P, Gabbay J (2004). Should mass screening for prostate cancer be introduced at the national level? Copenhagen, WHO Regional Office for Europe. http://www.euro.who.int
Nurgaliyev NS, Zhylkaydarova AZh, YI Ishkinin Edited by Nurgaziev KSh (2014). Guidelines for screening in the early detection of prostate cancer and to ensure its quality for target groups of the male population. Kazakh Institute Oncology & Radiology, Almaty.
Stamey TA, Yang N, Hay AR, et al (1987) Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med, 317 (15): 909–16.
Andriole GL, Crawford ED, Grubb RL 3rd, et al (2009). Mortality results from a randomized prostate-cancer screening trial. N Engl J Med, 360(13):1310-9.
Prorok PC, Miller AB, Kramer BS (2012). Response: Re: Prostate cancer screening in the randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial: mortality results after 13 years of follow-up. J Natl Cancer Inst, 104(10):793-794.
Schröder FH, Hugosson J, Monique J, et al (2009). Screening and Prostate-Cancer Mortality in a Randomized European Study. N Engl J Med, 360(13): 1320–8.
Roobol MJ, Grenabo A, Schröder FH, Hugosson J (2007). Interval cancers in prostate cancer screening: comparing 2- and 4-year screening intervals in the European Randomized Study of Screening for Prostate Cancer, Gothenburg and Rotterdam. J Natl Cancer Inst, 99(17): 1296-303.
Roobol MJ, Schröder FH, Kranse R, et al (2006). A comparison of first and repeat (four years later) prostate cancer screening in a randomized cohort of asymptomatic men aged 55-75 yr using a biopsy indication of 3.0 ng/ml (results of ERSPC, Rotterdam). Prostate, 66(6):604-12.
Hugosson J, Carlsson S, Aus G, et al (2010). Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncol, 11(8): 725-32.
Djulbegovic M, Beyth RJ, Neuberger MM, et al (2010). Screening for prostate cancer: systematic review and meta-analysis of randomized controlled trials. BMJ, 341:c4543.
Ilic D, O’Connor D, Green S, Wilt T (2007). Screening for prostate cancer: a Cochrane systematic review. Cancer Causes Control, 18(3): 279-285.
Ward R (2002). Storm over screening for prostate specific antigen Innuendo in article is insulting. BMJ, 324(7350):1392.
Duckworth MJ (2002). Storm over screening for prostate specific antigen. Right to choose is important. BMJ, 324(7350): 1392.
Balk SP, Ko YJ, Bubley GJ (2003). Biology of Prostate-specific Antigen. J Clin Oncol, 21(2):383-91.
Mikolajczyk SD, Rittenhouse HG (2003). Pro PSA: a more cancer specific form of prostate specific antigen for the early detection of prostate cancer Keio J Med, 52: 86–91.
| Files | ||
| Issue | Vol 46 No 7 (2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Prostate cancer PSA PHI Population-based screening Early diagnosis | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
