The Prevalence of Prostate Cancer ScreeJ}ing in Thai
Elderly
ANUPAN TANTIWONG, M.D.*, SUCHAI SOONTRAPA, M.D.*,
PICHAIYA SUJIJANTRARAT, M.D.*, NIRUN VA NPRAPAR, M.D.**,
LAW AN SA WANGSAK***
Affiliation : * Department of Surgery,
** Department of Pediatrics,
*** Department of Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractProblem : Prostate cancer is the most common cancer in elderly men in Western countries,
In the future, it may be an important problem in Thailand. At present, there is no evidence about
the prevalence and the outcome of screening in this disease.
Objectives : To determine the prevalence of prostate cancer in elderly Thai men and to
identify the most appropriate screening method for detection of prostate cancer in Thailand.
Materials and Methods : 928 elderly men from communities around Siriraj Hospital were
evaluated for prostate cancer by Digital Rectal Examination (DRE) and/or Prostate Specific Antigen
(PSA). Transrectal ultrasound guided biopsy (TRUS-Bx) which is the gold standard for definitive
diagnosis was performed in cases with an abnormal DRE and/or PSA. If biopsy could not be per
formed, intermittent follow-up with DRE and/or PSA were recommended.
Result : The prevalence of prostate cancer in Thai elderly men in the urban community was
more than 0.75 per cent and the prevalence of abnormal DRE and PSA was 8.7 and 17.3 per cent
respectively. The Positive Predictive Value (PPV) of both tests was 60 per cent and higher than the
PPV of an individual test. A screening program for prostate cancer starting with DRE may be more
cost effective.
Conclusion : The prevalence of prostate cancer, abnormal DRE and abnormal PSA in Thai
elderly men were more than 0.75, 8.7 and 17.3 per cent respectively which are comparable to the
prevalence in Western countries. It is important that we take an interest in this disease.
Keywords : Prostate Cancer, PSA, DRE, Screening
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